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ki <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />The Undersigned I lL <br />Hereby applies for permission to <br />J I� /AND PAVE 6N <br />At the tollo ing location_ <br />�A � <. -. 7 <br />(Work to be done) <br />0' <br />WE TMURF_ <br />7rs 5 <br />[ANLUCAP/N6 (TYF,) <br />NEW SIDEWALK <br />NO SCALE <br />AVE, <br />3614- <br />/ALLE Y <br />10264 <br />PERMIT NO. 75 141 <br />W COAVRETE PIW <br />-e x l_ rTIIV6 <br />/DE WRL e <br />DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br />NO SCALE save harmless the City of Everett from any and all <br />�`— claims for damages that may arise because of installa- <br />tion and maintenance of the improve ent hereto <br />applied for and fr{ither agrees to re ove same upon <br />notice from he Cit and to ie la blicproperty <br />� Y ff <br />damaged tj(et�y� / - /• <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBS'ITE. <br />CALL ENGINEE RIN 3 DEPT. 259 8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST f <br />Water Valve <br />Drainage z- <br />Curb & Gutter i4p�r0 ved <br />Sidewalk �(//JC// <br />9- 3-7s <br />Ins¢ector's Signatur <br />e <br />ate <br />Remarks <br />Note: Original to Customer 1 Copy to File 102 G 4 <br />1 Copy to Inspector <br />t0a cr SeYNIr e <br />Dae <br />Approved by , i �� / /� 7 f_ <br />Date Approved <br />