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rv�ren <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT•OF-NAY USE PERMIT <br />11036 <br />PEHMIT N0. � � 33% <br />The Undersigned l) � l. r�n �',�; x- �/ <br />Hereby applies for permission to � i� -� f,-� � <br />At the fotlowing location /�/ : C-- Aq i��� � j r � li nlJ� v,� .' <br />(Work to be done) <br />�l.s �; /a 7' , a :' li r_" /% <br />s <br />DRIVEWAY SECTION <br />NO SCALE <br />� V 1�� LIP � <br />�30"�— I 3�,� <br />-------�1'—J <br />. COPY OF THIS APPLICATION TO <br />BE P(1STED ON JOBSITE. � <br />i CALL [NGINEERING DEPT. 259�B811 ,i <br />; 2•; FIOURS BEFORE CONSTRUCiIOP! � <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gu[ter <br />Sidewalk <br />Inspector's Signature <br />�•e <br />Remarks <br />Note: Originat m Customer <br />The undersigned owner hereby agrees to ho�d and <br />save harmless the City of Everett from any and atl <br />claims for dama9et that may arise because of installa� <br />tion an i t�nance of the improvement hereto <br />aPP�� for an�d/lfurther agrees to remove same upon <br />n9tic�Am�h� Ciry� rep ce public property <br />�!Y�/.,� �' � ✓t;� ; <br />-,>`37�' � <br />Fee ' <br />Dept. prnv Is <br />� <br />Eaginecrs .i <br />Street <br />Communications <br />1 Copy to File '� 1�� 6 --- <br />1 Copy to inspector Approved by <br />Date Appraved <br />