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- APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> �everett � � � - <br /> �- -�e <br /> C�TY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT NO._ <br /> The Undersigned,_ � <br /> Nereby applies for perrrission to �� � <br /> —' <br /> At the folloviing loca[ion - ---- <br /> SKETCH � <br /> �Work to be done) � � <br /> F���' <br /> • tt <br /> `` �AR.AL� �� <br /> � 0 .'�� <br /> I <br /> � <br /> I <br /> I. <br /> � <br /> ORIVEwnY SECiION The undersigned owner hereby agrees to hold and <br /> NO SCaLE save harmless the City of Everett from any and all <br /> --- - -����J claims tor damages that may arise because of installa- <br /> �.—__ � <br /> tion anA maintenance of the improvement hereto <br /> �� i �� ��P �J apP�ied for and further agrees to remove same upon <br /> �=-- <br /> 30' � _ �.'-���� notice from the Ciry and m replace public property <br /> ' damaged thereby. <br /> Signawre of Appiicant ��� � <br /> ,;/ !G'i <br /> - � ' Address <br /> �COPY GF TI-115 �aPPLICAT10N l0 ��i <br /> I f3E POSTED ON JOf3SITE Telephone Number . <br /> CALL ENGINEERING DEPT,259-8811 _ � � <br /> I24 110UKS [iFFORE CONSTRUCTION Da[e <br /> CHECK LIST --- �-- - ---�— Fec <br /> W��er Vaive Dept. Approvals <br /> Diainage <br /> Cwb&Gutter Engineers__ <br /> Sidewalk i Water _ _. <br /> Street <br /> Communications <br /> Inspector's Signature � Traffic <br /> Planning <br /> �atc-- ------ --- <br /> Rr.marks -- ------- . . :, <br /> Approved 6y <br /> _ — � <br /> Datr. Appioved <br />