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everett <br />� <br />CITY ENGIfVkERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />Hereby applies for p=rmission to <br />At ihe following <br />(Work to be done) <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />[:V �J. <br />i`Jo JR�,_ �d <br />���a +u�c� e _ <br />�__ <br />;;�ry x�o„� <br />, t�.�,; � •_1 <br />OFIVEWAY SECTION <br />NO SCALE <br />r--- ----� <br />+I" LIP / � <br />L30�___— _.._�i'3—'1 <br />COPY OF THIS APPLICA'fION TO <br />BE POSTED ON JOBSITL. <br />CALL ENGINEGRING DEPT. 259-8811 <br />24� HOURS tiEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb 2L Gutter <br />Sidewalk <br />Inspector's Si9nature <br />–bate <br />� <br />PERMIT <br />�O.nqe. ?4�Y_, <br />I"J�'r .�.-_, <br />� -' <br />.�a , <br />�.: ,: �. <br />-'�--- �'-- <br />� <br />�i_ ��. : 4 � <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 />tion and maintenance of the improvement hereto <br />applied tor and further agrees to remove same upon <br />notice from the City znd to replace public properry <br />damaged thereby. <br />Signa[ure of Applicant <br />Telephone Number <br />Approved by <br />Date Approved <br />Dept. Approvals <br />0 <br />