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everen <br />e <br />CITY ENGINEERS <br />EVERETT,VJASHINGTON <br />APPLICATION FOR RIG�iT-OF-WAY USE PERMIT <br />1.0746 <br />PERId1T N0. � I -� �-� <br />r_ <br />The Undersigned � 1 ��C � 1 l_ —.� C�C�T � — <br />Hereby applies for permission to c.=- C7/ +�-'r T t�� - �� ��= T C C�NG �iu�� � <br />.:r_ ' t`.1.1i"� �-�'C�1�11�1(. / i_C��N \'\1_Li��L.�.� C.,��._> � ll-f=LIC_ �_�ti\1 � - <br />At the fcllowing <br />SKETCN <br />(Work ro ne donel <br />DRIVEWAY SECTIU,i <br />NO SCALE <br />�—__—_ _ _ _ _ . . _ —.! <br />I <br />I 30�ILIP ..__ .— I 30� I <br />r. '"Y �T. ..� <br />� COPY OF THIS APPLICATION TO I <br />' RG POST[D ON J06S1T[, I <br />�i Ci1Li_ ENGWEERWG DEPT. 259�8811 I <br />� H�:)I iNS FlFFOfiC CpNSTRUCTIGfJ I <br />CNECK LIST <br />Wator Valve <br />Dramape <br />Curb & Gu[ter <br />Sidewalk <br />Inspector's Signatum <br />-6ate <br />Remarks <br />Note: Original to Customer <br />7 Copy to File '� � � /i. � <br />1 Copy to Inspector <br />G <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett irom any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied (or and turther agrees to remove same upon <br />notice irom the City and.to replace public properry <br />dama�ed (hereby. ; �." � - <br />, /, '.� <br />Signawre'of Applicant <br />, .. <br />Address <br />-• 'i 7 <br />, i A.. �`; .; '/ <br />Telephone Number <br />Date <br />Approved by <br />Datc Approved <br />Dept. Approvals <br />