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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> evcrett <br /> . e � � <br /> CITY ENGINEERS <br /> EVERETT, N'ASHINGi-ON PERMIT N0. <br /> The Undersigned ___ <br /> Hereby applies for permission to <br /> At tlie following location <br /> SK[TCN <br /> 1Wuk to be dnnc) <br /> ORIVEWAV SECiION The wtdersignCd ownrr hereby agmes to hold and <br /> NO SCaLE save hannless the City of Evcrett from any and all <br /> f' - � `I claims for damages ihat may arise because of installa� <br /> i' UP J1 tion and maintenance of the improvement hereto <br /> ��__--� —�-�---�'__-_--'�_--�- -J aH,:�ied tor and lurther agrees to remove same upon <br /> '�-3�^ � � M'S�� — notice}rem the Ciry and ro replacc public property <br /> damaged thereby. <br /> SignaWre of Applicant <br /> CiIPYOf THISAPi'LICA'iIOW TO Address , <br /> iiE POSTED ON JOBSITE. . � � � � � <br /> Telephone Number <br /> �:�U_L ENGINFFRING DEPT. 259�8811 � . <br /> ?�� HOURS BFFORF CONSTRUCTION� Date <br /> CHECK LIST� Fee <br /> Wa�er Vaive Dept. Approvals <br /> Drainage <br /> Curb&Gu�ler En�ineers <br /> Sidcwalk Water <br /> Sucet <br /> Ccmmunications <br /> In:Pector's Siqnature <br /> TraHic <br /> Planning <br /> 6ate — <br /> Remarks <br /> Approved by <br /> Da[c Approved � <br />