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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />ki <br />10325 �,�y <br />CITY ENGINEERS — <br />EVERETT, WASHINGTON PERMIT N0._ <br />The Undei signed <br />Hereby applies for permission to U /..—D n <br />At the following location -7 1 I rl If 0 11111i L 1114v `1 111 i !1//1 I I( T 17 13 E L M'f) J LA <br />SKETCH T_ <br />(Work to be doge) — I -- c v u .7— <br />% <br />i; N 4"j <br />(15TIMrr LURG ti <br />GUTFtt-? <br />TRAFFIC 5NsA1 TO 6E <br />5 FE V& st:cT10N c NE/N DRIVeW14 V <br />NO SCALE <br />I" LIP <br />PO" i - f .— <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 />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />r <br />Inspe t rs Signature <br />--9 - i- -7 (�; <br />at <br />Remarks <br />Note: Original to Customer <br />i Copy to File 10325 <br />i Copy to Inspector <br />0s' <br />LA I <br />J <br />1 <br />/3 <br />Cr<. <br />tr � GR�i55 <br />LY15 TIME 19LLt_i! 1111I)TY <br />_ 1:714013175f U mc-w a)n) TH <br />PN03Qr Pi UNLl <br />OUN 62 LOU N) <br />1I - 13- %' <br />(Op F AGE ) <br />;:•7 r <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 fr m the City and to replace public property <br />dam-ji(thereby. it / 7 <br />`SigMerture �j AppNc�rr 7 <br />Address]_ — <br />Telephone Number <br />Date <br />Fee <br />Approved by Xz <br />Date Apprord <br />