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everett <br />� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />Here6y applies for permission [o <br />At the following <br />APPLICATION FOR RIGHT•OF•WAY USE PERMIT <br />11331 <br />� ,.: <br />PERMITNO. �� - � �! <br />_ r�'; <br />SKETCH %� !!. ;/A;i %�. ,�: �c �:�i` )�',r, <br />(Work to be done� � <br />DRIVEWAY SECTION <br />, NO SCALE— <br />r----- _-� <br />r��� LIP �, <br />i30.. J <br />--�i------- ---.}-'-°�-i <br />COPY QF TrIIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERiNG DEPT. 259-8871 <br />24 HOUHS BEFORE CONSTRUCTION <br />CHECK LIST <br />WTter Valve <br />Orainage <br />Curb & Gutter <br />Sidewalk <br />� � � - <br />i � <br />/ <br />Inspector's Si n ture ' "— <br />�7 � � ,_ ;� ;j <br />C�' 'i� <br />Remarks <br />1.1331 <br />INSPf�.Tn;,"ti rOF'i <br />The undersiyned owner hereby agrees to hold anA <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of instatla� <br />tion and maintenance of the improvement hereto <br />a�P��ed for and further agrees to remove >ame upon <br />notice from the Ciry and to replace pubiic property <br />damaged thereby. <br />Signature of Applicant <br />Address <br />Telephone Number �- <br />Uept. Approvals <br />Communications_ � <br />Approved by . <br />Date Approved - � � Q <br />i- _ <br />