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cverett <br />e <br />CITY ENGINEERS <br />EVERETT.WASH�NGTON <br />The Undersipned � <br />Hereby applies tor pertnission to <br />At ihe following <br />iWork to be done) <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT �� : <br />PERA1IT N0._ <br />._.i�'� i J I i i-. .. � . , . . <br />;���ce Ec�v���+�� ,�►� ,� - <br />� <br />fJ�; 4 <br />��,i,1�= :-�11 SiJ�' �.JAc.I� , <br />1 'i, ' <br />DRIVEWA� $ECTION <br />NO SCALE <br />�_. _ __- — _—. _ .__ +� <br />I" UP <br />4.30'.1.- y30 ^� <br />��COPY OF �I!II ; APPLICi,I �':;'�. -'; . <br />pC POSlED GIV JOL'Sll l:. <br />�I CALL ENGINEERMG DEPT. 259-8611 i <br />� 24 HOURS BEFORG CONSTRUCTIOtdi <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />�ate <br />Remaiks <br />The underslgnod owner hereby agrees to hold and <br />save harmless the Ciry of Everett from any and all <br />daims for damagee. that may arise because ot installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same uoon <br />notice from the City and to replace public property <br />damaged thereby. <br />Sigr.ature o( Applicant <br />r� <br />Address <br />Telephone Number <br />Date <br />Fee <br />Dept. Approvals <br />Engincers __ <br />Water --- <br />Street <br />Communications <br />Traf tic <br />Plannin0 — <br />Approved by <br />Uefn /11�ptucrd �'�� - � <br />� �- <br />