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evereR APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Q' 11 186 <br />CITY EVVGINEERS <br />EVERETT,WASHINGTON <br />PERMIT NO.7S- I� <br />The Undersigned '-A i ,� t <br />Hereby applies for permission tr 1'a/vST! ✓C ` A , <br />At the following location- 2.— <br />(Work to be done) <br />�E?LAcc As A ,Pr�c.cr of <br />,^0PS71?L4-T,o'j ACTIVITY <br />• luY7/)t. lJ64) ov213 <br />DRIVEWAY SECTION <br />NO SCA�E <br />30" 30" <br />E <br />=NEE <br />ATION TO <br />E. <br />EPT. 259 8811NSTRUCTION <br />WKLIST <br />7T <br />Inspec---tor'sSg ature <br />I <br />t> <br />PATZKs it <br />1 <br />I7r �/I <br />� T <br />�I <br />fa WCrL <br />2if <br />s/p,EwAt.1.;-' (ZWOOTJ <br />-M 11JLFT fl <br />The un�gne=Nner ere y agrees to hold and <br />save harmless the City of Everett from any ana all <br />claims for damages that may arise because of Installa <br />lion and maintenancE of the improvement hereto <br />applied for and further agrees to remove sameiupon <br />notice from the City i nd to replace public prc)Perty <br />damaged tfefeby. I <br />Telephone m r r F <br />u <br />Date 4q <br />Fee <br />Dept. Approvals <br />Engineers 7 <br />Communications <br />Traffic <br />Remarks — <br />11186 <br />Approved by iV4, f - <br />INSPECTOR'S COPY Date Approved <br />