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everett <br />�e <br />CITY ENGI��EERS <br />EVERETT,WASHINGTON <br />The UnJersigned i � v� / � <br />Hereby appiies for permission to <br />APPLICATION FOR RIGHT-OF•WAY USE PEkMIT <br />. <br />PERh11T <br />� 09�4 <br />-� - / <br />� � s �1 <br />At tlie following location �/L/ Sn �. Yif L'�'� S __ <br />�_ f,��.vwiL <br />SKETCH <br />(N'ork to be donc� <br />DRIVEWAY SECTION <br />NO SC4LE <br />.--_._.._ —.1 <br />I <br />�� �I'� LIP <br />�.30�+_ ._ _____ . _.___.�.30",1 <br />� <br />G(1PY 01- 11115 i�PPLIi;A"I IUIV TO.. . �� <br />BG POSTED UN JOE3SiTe. , <br />CALL ENGINEF.F ING DEPT. 2,g.AG i �'' <br />.'l1;fiR5 [iCf-pi�l ''(_lp;::;-j71�','�iIfR1 <br />,. <br />CHECK LIST <br />Water Valve <br />Drainaye <br />Curb & Gu[ter <br />Sidewalk <br />Inspecmr's Signawre <br />Remarks <br />No:^: Original �o Customer <br />, co,�� �o F�i� �� o r 4 <br />1 Copy m Inspector <br />5c,� /?:. ,4c �d � � <br />The undersi5�ed owner hereby agrees to hold and <br />save harmless t`�e Ciry ot Everett trom any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of ihe imprrc,-.mr.nt hereto <br />applied tor and further agrees to rr.move same upon <br />notice from the City and to replace pu6lic property <br />uate y <br />"� s <br />Fee / <br />Dept. Approvals7 <br />Enginecrs� � %/ � _ <br />Water_ <br />PI <br />Approved by <br />Dstc Approved <br />'f" <br />