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everett AF'PLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> . � L � ( S <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON PERMIT N0. <br /> The Undersigned � � <br /> Hereby applies for permission [o - <br /> At the following location � � � . � <br /> SKETCH <br /> (Work [o be done) <br /> � - — '— -- - � ' . %i:,`. 't ... _ ._ .,�i .___i�,_f —i'�� f'� 117� � . . <br /> , `-`" l.�J/ Tfl.-5 7f}/Z.)p/y�''� ( �� l>�4'!1I!-`�r i <br /> �� <br /> ��;: <br /> „,��;r <br /> •,� <br /> ,�`h: <br /> 5� ! <br /> +a.h t <br /> '1�y"; C Y . . . <br /> Y <br /> *�'`r"�}.`.� �R'.. . . <br /> e '� <br /> y� ��{»�t <br /> �t'd 5 w'yi:w. �.., �. . , . . , - . . . <br /> y{� <br /> �^j{. <br /> �F��� . <br /> i �� <br /> l <br /> . ...a... .. ��dt.�:.. <br /> DqIVEWAY SECTION The undersigned owner hereby agrees to hoid and <br /> , NO SCaLE save harmless the City of Everett from any and all <br /> f� � cla�ms for damages that may arise because of installa� <br /> I'� LIP tion and maintenance of the improvement herem <br /> 30' applied for and further agrees to remove same upon <br /> �30'+____� 1 � notice from the Ciry and to replace public properry <br /> _„� <br /> damaged thereby, <br /> Signature of Applicant -- <br /> COPY OF THIS APPLIC��TION TO Address <br /> BE POSTED ON JOBSITE. <br /> CALL ENGINEERING DEPT. 259�8811 Telephone Number <br /> 24 H(IURS BEFORE CONSTRUCTION Date <br /> CHECK LIST Fec <br /> Water Valve <br /> Drainage Dept. Approvals <br /> Curb&Gul[er Engineers <br /> Sidewalk — <br /> Water <br /> � Street <br /> I��Sti��Sign t r� � i Communications_ <br /> `(� � UL ��� � ,��� Traffic <br /> ? =� �� c� --� Planning <br /> - I . 1 1 . `� <br /> �te <br /> Remarks <br /> �_�_ ,. ;� C,' <br /> Approved by � � <br /> Dati� Apurnv�d 3 <br />