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I <br />' J <br />C17Y ENGINEERS <br />EVERETT, WASHINGT <br />The Undersigned ') <br />Hereby applies -for perml <br />At tfie following <br />(Work to be done) <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT 1113 4 <br />to <br />J <br />d <br />7� <br />DRIVEWAY SECTION <br />NO SCALE <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL. ENGINEERING DEPT.259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Watar Valve <br />_ Drainage <br />Curb &Gutter <br />Sidewalk <br />Inspector's Signature <br />PERMIT NO.—Z4-`%A__. <br />0 <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 />Street ���-�-------�_—_— <br />Communications____ <br />Traffic— - <br />Plannino <br />Approved by <br />CUSTOMER Date Approved <br />I. <br />