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evcretl <br />e <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned P\ 1 I l,l.i � <br />F�ereby applies for permission to <br />At the following <br />SKETCH <br />(Work to be done) <br />%•S, <br />i <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />10333 <br />���16 <br />PERMIT NO. / —.� � ��-':J� <br />� <br />/L" LL't_YE�'-° <br />� DRIVEWAV SECTION <br />NO SCALE <br />� f.--- 2¢- --- --�j <br />f I�� LIP <br />�30•j•— -4-- _. ___-_ _._ ��3� <br />'� COPY OF THIS APPLICATION TO <br />'� PE POSTED ON JOBSITE. , <br />� CALL [NGINLCAING DEPT.259-881 i <br />�� I ��1 HOt'RS [tGFORE CONSTf7UCTI0f•J� <br />CHECK LIST <br />� Water Valve <br />Draina9e <br />Cwb & Gutter <br />Sidewalk <br />Inspector's Si9nature <br />_� _ <br />Femarks <br />Nore: Originai w Customer <br />� Copy to File <br />� C��py tu Impector <br />`�;-.',�-� <br />cn„�s; ; GG�NG. <br />,.�z , ✓ � <br />�th �; j !��C % • <br />- , ,• <br />�:_ _���--- � � <br />F -�- <br />_ := l� <br />l- �'''} <br />ct ; <br />ti�'.. . <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any aid all <br />clainis for dama�es that may arise because o' msta la� <br />tion and maintenance of the improvement hereto � <br />applied for and further agrees to remove sam� upon � <br />notice from the City and to replace public property <br />damage,� he y. <br />' � ����.li-G� _� <br />Si—g�nature of App�icant <br />1// E, r/!t rJ /2//7l.E 0.2 • <br />Address <br />.�Sf 3�//� <br />Telephone Number <br />Date <br />'�i2. cc, ,___._ ��. / 2 /,� -� �� <br />Fec <br />1 lJ �.� J APProved bY / /�.�4/%s <br />� ' <br />Date Approved <br />7s' <br />1- <br />