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e�Yren , APPLICATION FOR RIGHT-OF-WAY USE PERMIT 112 81 <br /> � • <br /> � �`" �- <br /> CITY ENGINEERS . , <br /> E�'ERETT,WASHINGTON PERMITNO. ' ' ' <br /> The Undersigned _ _ <br /> Ficreby applies for permission to <br /> At the followiog Iocation /' <br /> ��-iR��R:�(.C.!" <br /> SKETCH / <br /> (Work to be done) � <br /> �.s, i � "TF�fICn�i�1G , - <br /> ORrvEWav SEciiON T1ie widersigned owner here6y agrees to hold and <br /> NO SCALE ,evc harmless the City of Everet[trom any and ail <br /> �--�-- -- – - � --� daims for damages that may arise because of installa� . <br /> ���� �i� tion and maintenance of the improvement heretn <br /> applied for and further agrees to remove same upon <br /> �,30'�_- . . . �3�"�j notice fwm the City and to rep�ace public property <br /> dnm,�qed thereby. <br /> SignaWre of Applicant <br /> � COPY OP TNIS APPLICnI'JN i0 Addrnss <br /> � BE POSi�E-U ON JOBSITE. I ' � <br /> Telephone Number <br /> CALL ENGINEERING D[PT. 259�8811 I <br /> � 24 HOURS 6EFORE CONSTRUCTIONI Date <br /> CHECK LIST Fee <br /> Water Valve Dept. Approval5 <br /> Drainage <br /> Curb& Gutter Engineers <br /> - Sidewalk W���� <br /> Street <br /> Communications <br /> I.ispector's Signaiu re Tratf ic <br /> Plamiing <br /> Oate — <br /> Remarks <br /> Approved by <br /> Date Approved 0 <br /> -�.__ <br />