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everett <br />� <br />' � <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the followir� <br />(Work to be doncl <br />APPLICATIOh FOR RIGHT-OF-WAY USE PERMIT �, ;� %, <br />---`'- <br />�� <br />� <br />DRIVEWAV SECTION <br />NO SCALE <br />�--- � <br />I" LIP <br />, � , <br />1..30.}.. _ _ _ _____ _ , 30 I <br />t <br />COPY OP THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGIN[ERING DEPT. 259�8F311 <br />24 HOURS BeFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewa�k <br />Inspector's Signature <br />—bate <br />Remarks <br />PERMIT N0. <br />� <br />The undersigned owner hereby ayrees to hoid and <br />save harmless the City ot Everett from any and all <br />claims'�r damages that may arise because of insta�la- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice irom the City and to replace public properry <br />damaged thereby. <br />Signature ot Applicant <br />Telephone Number <br />Date <br />Dept. Approvals <br />Communication! <br />Traffic <br />Planning <br />Approved by <br />Date Approved <br />0 <br />