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everetl APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> . � <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT N0. <br /> The Undersigned <br /> Hereby applies for permission to <br /> At the following location_ <br /> SKETCH � � � " � <br /> (Work to be done) <br /> DRIVEWAY SECTION Thc undcrsigned owner hereby ac�rees to hold and <br /> NO SCALE save harmless ihe City of Ererett from any and all <br /> F - -- - -- -.i <br /> claims for damages that may arise because o(installa� <br /> ��� LIP tion and maintenance of the improvement hereto <br /> �30'+__ . _ _�30" I applied (or and further agrees to remove same upon <br /> �1 notice (rom the City and m replace public properry <br /> damaged thereby. <br /> Signature o(Applicant -- <br /> �COPY UF TfIIS iAPi'LICi�TIU;�! TV Address <br /> I f3E POST[D ON J06SITE. <br /> CFlLL ENGINEERWG DEPT. 259�8811 I Telephone Number <br /> 24 FIOUfiS BEFORE CONSTRUCTION� Date <br /> CHECK LIST Fce <br /> Water Valve <br /> Drainage Dept. ApproValS <br /> Curb&Gutter Engineers <br /> Sidewalk <br /> Water <br /> Strcet _ <br /> Inspector's SignaWre Communications <br /> Traffic <br /> Planning <br /> —Bate <br /> Rcmarkt <br /> Approved by <br /> Datc Approvcd Q <br />