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a.- APPLICATION FOR RIGHT•UF-WAY USE PERMIT <br />everett -. <br />�: e . <br />CITV ENGINEEEIS <br />EVERETT,WASHINGTON <br />The Undersigned �_. �.c ':{ .�•"� <br />Hereby applies for permissmn to C,.�n�f r: c'L z, i;' G'l�� � <br />At the following location <. z o n�., /� ��- � i�l. <br />SKETCH <br />� . (Work to be done) <br />� <br />I <br />�0651 <br />rERMITNO. /�VZ/� <br />DRIVEWAY SECTION <br />NO SCALE <br />� � <br />� I'� LIP � <br />30" __ ..__ 30�� <br />COPY OF THIS APPLICATION TO � <br />BE POSTED ON JOBSITE. <br />CALL ENGWEERING DEPT. 259-8811 <br />24 HOURS BEf-OflE CON;TRUCTIONI <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspe�nawre <br />�' � � %� <br />a�ie <br />Nmc: Original to Customer <br />7 Cnpy to File � p� 51 <br />1 Copy to �nspectar <br />s <br />r� <br />.w�, ts <br />The undr rsigned owner hereby agrees to hold and � <br />save harndess the City of Everett from any and all . <br />claims for damages that may arise because oi install8• , <br />tion and maintenance of the improvement hereto � <br />applied (or and further agrees ro reinove same upon �� <br />notice from the Ciry and to replace publir. properry � <br />damag ereby. �-- <br />� <br />Signature of Appli nt <br />—��l l� � W�( q Ct S�tihn � � <br />Address <br />�%%S" S�iZ! <br />Telephone Number • <br />__. � � , <br />Fee , l 1' {S—,����?L <br />Dept. Approvals <br />..� �. .:f, .. <br />—`. � ; Traffic _ <br />� Planning _ <br />, 5�� I.�G%.�,�ax., i� <br />Approved by <br />Date Approved <br />