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everett <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the following <br />(Work to be done) <br />���� � DRIVEWAV <br />I NO SG <br />1 rrr����----------- <br />� \ 11 UP <br />� � <br />� �,30�_ <br />� <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PERMIT <br />11217 <br />_� <br />__ The ury�p,�sjyp-dyvner reby agrees to hold and <br />save harmless tiie f ity o Everett from any and all <br />claims for c_c agas that ay arise because of installa� <br />tion and mai��i!anance of the improvement hereto <br />applied tor and ructner agrees to remove samc uoon <br />��30' notj�e_Crom the City and to replace public properry <br />---, '�"--"'—'� damaged there6y. <br />.tr;. �r <br />v — � '� Signature of ApPlicant <br />COPY OF THIS APPLI(.l�TION l G � <br />BE POSTED GN J06SITE. I <br />CALL ENGINEERING DEPT. 25�J-8611 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Watar Valve <br />Orainage <br />Curb & Gutter <br />Sidewalk <br />Inapector's Signature <br />Telephone Number <br />Date <br />Dept. Approvals <br />Communications <br />