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^ve�etl APPLICATION FOR RIGHT-OF•WAY USE PERMIT , <br /> ,�. � 111R5 <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMITNO. -- �i � <br /> The Undersigned / � ' � � <br /> Hereby applies for pertnission to �- � <br /> At the following location - / i; . <br /> SKETCH <br /> (Work to be done) <br /> d <br /> �.�� l�E, r i f:� l�'�.r;� i- �_.`, ._: , _ <br /> `1 '��-� (,, r�J('.►f <br /> �..% • �•Vvu;�`I CUTy �Cl�Cf�C� t�.fl � <br /> - n � � <br /> . .��- <br /> , ; , , _.�� _. <br /> : . � <br /> DRIVEWAY SECiION The undersigned ownen c�reby agrees to hold and <br /> NO SCALE save harmless ihe City of Everett from any and all <br /> � - �-� claim� for damages that may ar�se because of installa� <br /> �I'� LIP —�� tion an� maintenance of the improvement hereto <br /> �30'� _ _ ___ �3p" � applieC tor and further a9rees to re�nove same upon <br /> �1 notice from the City and to replace public properry <br /> damaged thereby. <br /> Si�nature of Applicant <br /> COPY Of THIS APPLICFaTION TC � Address <br /> BE POSTED ON JOBSITE. <br /> CALL ENGINEERING DEPT. 259�6611 <br /> Telephone Num�er <br /> 24 HOURS BEFORE CONSTRUCTIONJ Datc � <br /> CHECK LIST Fee -- <br /> Water Valve <br /> Drainage Dept. Appl'ovals <br /> Curh&Gutter Engineers <br /> Sidewalk <br /> Water <br /> �� ��i � � � ,%�/ Stree[ <br /> � � -- _ Communications <br /> Inspectoi s Signature- Tra(fic <br /> -, _. ? ,% Planning <br /> l�ate �� — <br /> // <br /> Remarks , <br /> �_ �. � �� �7 <br /> Approved by — — <br /> IhISFCCTOR'S rCi'1 Datc Appioved �-�--- -- � <br />