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everetl <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />Hereby applies fo <br />APPLICATION FOR RiGHT-OF•WAY USE PERMIT <br />10643 <br />PERMIT N0. __ �� � L� <br />(Work to lx done) y� , . � <br />� \ I\'� <br />�� `. <br />DRIVEWFV SECTION <br />NO SCAIE <br />�-- —_—.._ � <br />� I�� LIP <br />� <br />I 30y__ _ __.1.3J <br />r � ---_ - r <br />� COPY UF TH1;.9PPUC/�TIOiJ l0 ---��� <br />[i� POSTED ON JO�SITE. <br />. %�LL ENGINEFRIhG DEP�. 259-8811 I, <br />,. : Ii0uR5 P�C�r�Bf CONSTRUCTION� <br />CHECK LIST <br />Water Va�ve <br />Drainage <br />Cur6 & Gutter <br />Sidewalk <br />Inspector's Signawre <br />ate <br />Remarks <br />Note: Original to Customer � O��� <br />7 Copy to File <br />1 CopY to Inspector <br />The undersigned owner liereby agrees to hold and <br />save harmless the City oi Everet[ (rom any and all <br />claims tor damages tha[ may arise because of installa� <br />tion and maintenance oi the improvement hereto <br />applied tor and further agrees m remove same upon <br />notice from the Ciry and to replace public property <br />damaged thereby. ,,, . f <br />17Lta. f?/_,,,�> .��;.. ,�.,� �,,I' <br />Da[e <br />r`IJ <br />r i� ���i�(,: <br />,.o � <br />�----'_—y'-- <br />Dept. Approvals <br />Engineer; <br />Water <br />Street l� k� � ' � _ <br />Communications <br />Tratf ic <br />/ // �i 6 <br />Planning i .��� <br />Approved by <br />Date Approved <br />