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� �����n <br />� e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the following <br />IWork to be done) <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />DRIVEWAY SECTION <br />NO SCALE <br />� � <br />��'� LIP —� <br />L.3��.__ __ _.-- . ._.._'i3O,'1 <br />COPY OF THIS APPLICATION TO l <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT.259�8fli1 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Guttcr <br />Sidewalk <br />Inspector's Signature <br />PERMIT <br />� �..164 <br />,._. �_�d..� i�-'- 1�., ..,��;�('t 1�. . ��_. <br />� iUE. <br />�2�.P�Acc (� �o4T sQT�v►� ��- <br />DAuCrE20U5 �iDL i,clQL1� C!J <br />tlo r�i �T��cEi. <br />—� C NJS7 Rll C 1` Uj Fi LE L C L{ Q I fL f(.!}+S1 P <br />� p usT�. � i T 1�Ei.�) � I D Cttl,C1 t..K li l� <br />Cu�t3 ra Sa�T�-� r�oPFr?Ty, <br />� 1UC- . <br />, ; ��ue;- �JG�� 2.� F�aor <br />,vE i.1�q�; �, ��.�ct+ �^oucr;�-. <br />- � :� � _ <br />�'fhe undersigned owner hernby agrees to hoid and <br />save harmless the Ciry ot Everett from any and all <br />claims for damages [hat may arise because oi installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the Ciry and to rep�ace public propr.rty <br />damaged ihereby. <br />SignaWre of App6cant <br />Telephone Number <br />Dept. Approvals <br />Communications <br />Plann <br />Approved 6y <br />Datc Approved <br />