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APPLICATION FOR RIGHT-OFWAY USE PERMIT <br /> • e�eretl <br /> . � . <br /> CITY ENGINEERS <br /> EVEHE77, WASHINGTON PERMITNO. is- <br /> _�' . <br /> The Undersign�d -� •� � - _ <br /> Hereby appli�s for permission to '��� ".T,�: � /� � <br /> c <br /> At the following location - � � 'J —'�n i �-J� '- T, _ <br /> SKETCH <br /> (Work to be done� -, �, �, <br /> \ .- <br /> �� � 1 <br /> __ � I <br /> , " � ) � ( ��,.�. <br /> i�;� _ - �I.� <br /> ; � , , ,_, <br /> � � ' <br /> � � <br /> . <br /> ' , ✓. - <br /> ` , <br /> DRIVEWAY SECTION Thr,undersigned owner hereby agrees to hold and <br /> rvG SCaLE save harmless the City oi Everett from any and all <br /> �" --- - - - �- -- — - --� claims for damages that may arise because of insta�la� <br /> (I" LIP � tion a�d maintenance ot the improvement tereto <br /> � applied (or and further agrees to remove same upon <br /> �30'y _ _____ _y3�'J notice (rom ihe Ciry and to rep�ace public property <br /> , - - - -�- - - � - � damaged thereby. � _ � <br /> Signawre of Applicant <br /> � . ' :. .:�: . . .. <br /> �COPYOI� lHISF�PP�li;nl ',: ,�, 1�; Address _. _ �� � � <br /> RF POST[D ON JOBSI fL = ` -'� , <br /> Telephone umber � <br /> CALL ENGINEERING GFPT.259�IIR17I '-� �1. . /f� __ <br /> 24 HOURS 6FFORF CnNSTRUCTIOf:l Date '" <br /> �- ----- -- _. . <br /> CHE�K IIST Fee <br /> Waier Valve Dept. Approvals <br /> Drainage <br /> Curb&Gutter 5ngineers ____._. — __ <br /> Sidewalk � Water __._ <br /> Street <br /> Communications <br /> Inspector's Signature Tratfic <br /> Planning <br /> —6ate ----— <br /> � <br /> Remarks <br /> � <br /> ApProved by <br /> �!/��'Jj ,�%i;��. <br /> Date Approved � �%..J i " � 9 <br />