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W <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT 11101 <br />The Undersigned -ii , L � — '� h1 <br />PERMIT NO. <br />Hereby applies for permission to <br />At the following location / % 1- i / <br />(Work to be done) <br />L y <br />Ct'LTtiG. <br />LET. <br />3O, <br />41 Sr - 7- <br />DRIVEWAY SECTION <br />NO SCALE <br />rI� <br />I ` iI" LIP i <br />30" 30" <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />11 i 01 <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of irstalla <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same u;)on <br />notice from the City and to rep!ace public property <br />damaged thereby. <br />Signature of Applicant --- <br />�Oad �-& it <br />Address <br />Telephone Number <br />Dept. Approvals <br />Communications <br />Approved by <br />INSPECTOR'S. COPY Date Approved <br />