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APPUCATION FOR RIGHT-OF-WAY USE PERMIT ��4�8 ��' �,�
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<br /> CITY ENGINEERS PERMIT N0. � � �
<br /> EVERETT,WASHINGTON _ _. _
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<br /> The Undersigned �-��! � �� ' "'� �(/ � �
<br /> Hereby applies for permission to
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<br /> DRNEwAY SEC710N The undersi9ned owner hereby agrees to hold and
<br /> � save harmless the City oi Everett ftom any and all
<br /> �� NO SCALE yI�Y� �'tA claims for damages that may arise because of installs-
<br /> � I'— 25' � . f, � ..' tia� and maintenance of the improvement hereto
<br /> I" LIP I�.� ! '.�� applied for and further agrees to remove same upon
<br /> I �%{� notice fro the City and to repl_�ac_e__p��,ub,,ttl''ic properry
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<br /> ' COPY OF THIS APPLICATIOiV ��O �I ����/�� .
<br /> RE POSTED ON JOBSIT[. Telephone Number
<br /> . CALL GNGINEERING DEPT. 259�8£311 II Date
<br /> ,�. �IOUI�SiiLFOtiECOfd;TRUCIII��I� � ��.i_i ._%�.':y"�- �i �7�0
<br /> Fee
<br /> CHECK LIST pe t, provals
<br /> � Water Valve
<br /> � Drainage Enginee
<br /> Curb&Gutter /3, � P� e 1 -� "�G
<br /> Sidewalk , Water
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<br /> ; .- „�`�,- ' Street�._.�1
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<br /> � y JrH , � i,':. Communication;
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<br /> Inspeft r's ignature � V J Traffic ,
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<br /> Planning "' ' �'�`�
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<br /> Remarks
<br /> Note: Original to Customer n p � / /
<br /> 1 Conv �� File ' 1 ,�}�, p Approved 6 �
<br /> 1 Copy to luspector �'
<br /> Date pproved
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