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everetl <br /> APPLICATION FOR RIGHT-UF�WAY USE PERMIT <br /> e 11011 <br /> CITY ENGIN[ERS <br /> EVERETT,�A�ASHINGTON PERMITNO. 7 � �O _ '�. <br /> TheUndersigned / i,��J/�. � l-�J t1E � , <br /> Hereby app�ies for permission to _/� ; .t/S T� /C �� Q 2 S� ��i�-/q,;� ���i r' <br /> � At the foilowing location S i ^�l_�.� q�../,� � � <br /> SKETCH <br /> '. (Work to be done) <br /> SE g R''�/i�il��> <br /> I I� <br /> I <br /> , DRIVEWAv sECTION - The undersigned own�r here6y agrees to hold and <br /> NO SC4�E save harmless ihe Cit� 01 Everett from any and all <br /> �I � - - � � --� claims for damayes that may arise because of installa� <br /> � �i^ i.lP —�-�1 tion and mu�ntenance o( the improvement hereto . <br /> � � J applied for and further agrees to remove same upon <br /> 30'—�,— <br /> j �. I 30� notice from the City and to replace public property I <br /> T <br /> i d/am.�aged thereb��y. <br /> CNYM�LnLH�if /'c/$� ���� '. <br /> Signature of App icanl t � '� <br /> ��' /� r a�17 �-,i�,. r-- 5�a�3 <br /> COPY OP IHIS APPLICATION TO Address �� <br /> BE POSTED ON J06SITE. �Sj-�so� �� <br /> � Tele hone Number ' <br /> . . CALL ENGINEFRING DCPT. 7!iD�3;'11 ��7 <br /> ., i :�1 ii�!'.lf?5 flCf OI�L C.G':3 i HUI�.'1li �.': Date y�� �� <br /> J <br /> ,' CHECK LIST pee � �� - i <br /> Water Valve � <br /> DrainagP Dept. Approvals <br /> Curb&Gutter Engineers�������= '�, <br /> Sidewalk I <br /> Water_ <br /> Street � <br /> Communications � <br /> Inspector's Signature Tralfic �� <br /> Planning <br /> �ate — -- <br /> Remarks — i <br /> Note: Oriyinal to C��stomer y /� q � <br /> lconvtoFile 11�1�1 � <br /> 1 Copy to Inspector Approved 6y <br /> Datr Approved <br />