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ki <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10531 <br />PERMIT NO <br />The Undersigned L r r n, t l-i . r F a, .. n r r <br />Hereby applies for permission to !.. „ { r rr r 1 - 7 A � L ! L)A, '+ <br />At the following location <br />SKETCH <br />(Work to be done) <br />1115-77-q44- <br />I�r <br />DRIVEWAY SECTION <br />NO SCALE <br />I" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />L14 HOURS BEFORE CONSTRUCTION <br />ate <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10531 <br />1 Copy'to Inspector <br />3rIs�N—� <br />CliLf/— er- <br />i i.'n•L�c <br />I <br />r; �I <br />LULYE/GT' <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa <br />lion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereb�/ <br />Signatur Applicant <br />Address <br />1-/KG 7a yU <br />Telephone Number <br />;71 -7 ` <br />Date <br />Fee <br />Dept. Approvals <br />Engineers__ <br />Water_ <br />Communications_ <br />Traffic_. <br />Planning_. ' _ .. <br />Approved by . <br />Date Approved <br />