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cvcretl <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � e ; sos�4 <br /> �_ _�. <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT N0. �' �' y U <br /> \ / <br /> The Unoenigned � `•.. <br /> Hereby applies tor permission to � ,/ <br /> At the following location � _ <br /> SKETCH <br /> (Work to be done) <br /> ; _ - � � -,-� c , .- > <br /> � <br /> ! <br /> . <br /> , DRIVEwAY SECiION The undersigned owner hereby 3grees to hold and <br /> NO SCaLE save harmless the City o(Everett from any and all <br /> � � - -� claims tor damages that may arise because of installa- <br /> �I" LIP �� tion and maintenance o( ihe improvement hereto <br /> applied for and further agrees m remove same upon <br /> 4„30'+__ ___ _ I 30� nmice from the City and to�eplace public property <br /> �t' <br /> damaged ereby,r '� .' ,� <br /> iu'- ,/� -�1 � -=-r�`f� <br /> Signature o A��i�� <br /> -��...��( .��� <br /> �COPY OF THIS APPLICl�710fJ TO ' Add'ess—�—� � y� <br /> BE POSTEU ON JOBSITE. � _-,'-'�� j — 2 ,��j <br /> i CALL ENGINE[RING UEPT. 250-S3�s1 i TelephoneNumber <br /> 7-i liu'��fte �:,f-hORL CO�;SI NI,'I�i�07!'. Dale <br /> ..i <br /> CHECK UST Fee � <br /> � Water Valve <br /> Dept Approvals <br /> Drainage <br /> Curb&Gutter o� , �` / Engineers � <br /> Sidewalk y - �� t' ,-n�, 4:� r,�f��,� •7 ��'i�:� — <br /> i ,. '��'�., . . . / r Water � - <br /> •'^�b� '�� ` Sireet � <br /> � <br /> � Communications <br /> I nspector's S igna W re Trat(ic <br /> Planning_ <br /> -bate --- ---- �;' <br /> Remarks — - <br /> Nore: O�iginal to Customer — — - <br /> i co,�Y,o Fa� � (�c. q _ _ <br /> 1 Copy to Inspecto� - � Approved 6y <br /> Date Approved <br /> � <br /> � � � <br />