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i <br />CITY ENGINEERS <br />EV E R ETT. WASH I N GTON <br />The Undersigned I <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10813 <br />7— PERMIT NO. — <br />At the following location cN�2`1 Ir ✓�.-�': ram.•, �'� -- <br />(Work to be done) <br />SlG <br />DRIVEWAY SECTION <br />NO SCALE <br />1" LIP p <br />�30 <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-6811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECKLIST <br />Water Valve �� <br />Drainage <br />Curb & Gutter s <br />Sidewalk �Na ,vr <br />Inspector's Signature <br />Remprks <br />Note: Original to Customer <br />1 Copy to File 10813 <br />1 Copy to Inspector <br />The undersigned owner hereby agrees,to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant <br />Address <br />Telephone Number <br />Date <br />Fee —� <br />Dept. Approvals <br />Engineers -? <br />✓ - <br />Communications <br />Approved by <br />Date Approved <br />