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everetf � <br />e �: . <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />'ne Undersigned <br />Hereby applies for permission ro <br />At the following location <br />(Work to be done) <br />APPLICATION FOR R:GHT-OF-WAY USE PERMIT <br />�i�i% %' � 1.�"i1 <br />DRIVEWAY SECTION <br />NO SCALE ' <br />r - --� <br />I" LIP _� <br />L.30«l.__ _ ___ i'30�"1 <br />r <br />� COPY Of- THIS APPLICATION TO <br />BE POSTED CN JO�SITE. <br />CALL CNGINEERING D[PT. 259�8811 <br />I2�1 HOURS BEFORE CONSTRUCTIONI <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Guttcr <br />Sidewalk <br />Inspector's Siynature <br />� -� <br />PERMIT <br />r F:" ) i.,'�, "T �;:.'��.�1 P.11 .�. <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for dama9es Ihat may arise because of installa� <br />[ion and maintenance of the improvement hereto <br />applied for and further agrees [o remove same upon <br />notice (rom the City and to replace public properry <br />damaged thereby. <br />Signature of Applicant <br />Telephone Number <br />Date <br />Dept. Approvals <br />Communica[ions <br />Approved by <br />Datc APP�oved � <br />