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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />CITY ENGINEERS PERMIT NO.jT� <br />EV E [I ETT. WASH I N GTON <br />The Undersigned JI J P / <br />Hereby applies for permission to <br />At the following <br />SKETCH <br />(Work to be done( <br />Co"'��] ,�Qy� �ULQ �.d�i� 2I.G-n�sL., .�y,(:ZC. cz..��tC�i�-• a-�lGf_' . <br />+ r c t ... lT" � <br />j 4: (, 3 7 t <br />r <br />t( q <br />` DRIVEWAY SECTION <br />NO SCALE <br />I <br />I'LIF <br />COPY OF THIS APPLICATION TO <br />BE POSI-ED ON JOBSITE. <br />CALL ENGINEERING DEPT.259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve 71 <br />Drainage <br />Curh & Gutter <br />Sidewalk <br />tor's Signature <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />' <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applisd for and further agrees to remove same upon <br />notice from the City and to repla public property <br />damaged er y. <br />!' <br />Signature of Apphca t <br />i <br />Address <br />Zr%-`/673 <br />Telephone Number <br />oef _T1. 75- <br />Date <br />Dept. Approvals <br />Water <br />Communications <br />Remarks .I q&�l_n <br />Approved by <br />