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APPLICATION FOR RIGHT-OF-WAY USE PERMIT � , <br /> evcrett - <br /> 1 � __ ._ �._ � ..J <br /> CITY ENGINEERS � <br /> EVERETT,WASHINGTON PERMIT N0._ _ �� .�% <br /> The Undersigned <br /> Hereby applies for permission to <br /> At the following tocation <br /> SKETCH <br /> (Wark to be donel <br /> � ; ---- -- T-.�---�:T---4�----�--- <br /> ��-����fc- <br /> � �z � i <br /> � �5,��';� ���, �i�t ( . _ �' ,�LE?C �°i <br /> � , <br /> . .�;�#.. ��- 1 �� <br /> � ��,���s <br /> �� <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all � <br /> � - — -"i claims tor damages that may arise because of installa� <br /> �p L�p tion and mainrenance of the impwvemeni hereto ' <br /> applied tor and turther agrees to remove same upon <br /> �30'�_ _ __ � _ I 30"� notice from the Ci[y and ro replace public property <br /> - •T� <br /> damaged thereby. <br /> Signature of Appiicant <br /> r--��--- -- -. .. . Address <br /> ICOPY OF THIS APPLICA71Uf1 �i�0 i � <br /> E3E FOSTED ON JOBSITE. � <br /> Telephone Numbcr <br /> CALL ENGINEERING DEPT. 259�8811 <br /> 24 HOURS BEFORE CONSTRUC110N Date <br /> . CHECK LIST Fee <br /> Water Valve De t. A <br /> Drainage p pprovals <br /> Curb&Gutter Engineers <br /> Sidewalk Watcr <br /> Street <br /> Communications <br /> Inspector's Signature Trafiic <br /> P�anning <br /> ate <br /> Remarks — — <br /> Approved by <br /> � Date Approved � <br /> -�.. <br />