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APPLICATION FOR RI;,HT•OF-WAY USE PERMIT <br /> � �everetl . _ . . _ <br /> � <br /> CITY ENGINEERS <br /> • EVER€TT,WASHINGTON PERMIT NO. <br /> The Undersigned <br /> Hereb•y applies for permission to <br /> At the following location <br /> SKETCH <br /> (Work to be done) <br /> , � ;,. <br /> � � � ��,,. <br /> . I , , , , <br /> , �� � , ,. ,�r��,;,,� <br /> y <br /> � . �� <br /> -- -- --- .��('�. r� -- ----- -- <br /> Iv I.� " co�cr,r:ri= I�i�i���i i II �= To I.;�� <br /> � , i,_ ii � ,� • �rJ - <br /> i�,i-;rn«co �- � � ri�v�, <br /> ir.� '; 7;•u� ri% \ I ,�, i <br /> � ;_-_��-�--�� � � � � � , � _' � �_- -----�=-ly <br /> �% <br /> --- �_. __ Ff. r. \_� N�71.�- !�iUr . - . ,. I :- du • .�,; r„- - �; . <br /> � / i )�� ` , /.�. . �v � ,..- T / ; � ,•' <br /> \/./ . - I , '., ��-I,� I i�1 . i I� ; t i. —. ----- �— --------_._.. <br /> DRIVEWAv SECTION The undersigned owner hereby a9rees to hold and <br /> NO SCALE save harmless the City of Everett trom any and all <br /> ''— --�-----�-� claims for damages that may arise because of installa� <br /> �i,. ��P� tion and maintenance oi the improvement hereto <br /> � applied tor and further agrees to remove same upon <br /> I 3)'� _ , y30'� notice from the Ciry and to replace public property <br /> �� —. ._ _—__ _ <br /> damaged thereby. <br /> Signawre of Applicant <br /> � COPY OF THIS APPLICATION TO Address <br /> BE POSTED ON JOBSITE. � � <br /> Telephone Number <br /> CALL ENGINEERING DEPT. 253-8811 . � <br /> 24 HOURS BEFORE CQNSTRUCTIONI Date <br /> CHECK LIST Fee r,� � <br /> wa�er vaive Dept Approvals <br /> Drainage <br /> Curb&Gutter Engineers <br /> Sidewalk Water <br /> Stree[ <br /> _ _1 ___ Communications <br /> spec or's��3nawre <br /> Tratfic <br /> � ,,, � /� 7 Q' Planning <br /> V <br /> �te <br /> _o�_��,or_r��� <br /> Remarks — <br /> Approved by <br /> Date Approved � <br />