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APPL.ICATION FOR RIGHT-OF-WAY USE PERMIT <br />_ everytt <br />� <br />CITY ENGINEERS <br />EVERETI', WASHINGTON <br />The Undersigned _ Q� V�� <br />Hereby applies for permission to _ <br />At the following location 4l7 - 4 9 rM .� �. S. ��%. <br />SKETCH <br />(Work to be done� <br />E"DG,E OF E,YISTING <br />PAGE/Y/E/V T <br />i <br />Zs' q-9;;, ST. S.W, <br />—�----- -- ----- - <br />ORIVEWAY SECTION <br />NO SCALE <br />� /5 —'{ <br />+��� LIP ___�� Q�% �; 1 <br />30'�_ . _..�b � ..--. �.30 � <br />COPY OF THIS APPLlCATIOiJ TO I <br />BE POSTED ON JOBSITE. �� <br />CALL EPJGINEERING DEPT. 259�8811 I, <br />Zd HOURS 6EFOR[ CONSTRUCTIOf�: � <br />CHECK I_IST <br />Water Valve <br />Drainage <br />Curb & Gut[er <br />Sidewalk <br />,� � �� : � �'� � <br />���, , li 1 ��-�' <br />Inspector's Signature <br />'� ) > _ � <br />ati�e — <br />Remarks <br />Nole: Original to Customer <br />, �aPY �o F��� 1 ��.1 g <br />1 Copy to Inspeamr <br />10118 <br />PERMIT N0. ����/ <br />ltl <br />n�W <br />T D�►M <br />Na ,SCALE <br />�, <br />13.8� <br />� <br />-/aREA 7"a .8E D�'£D1=D TD Cl T Y <br />A-1' LATEI� D4�E <br />The undersigne owner ereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claim� for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from thg Ciry and to replace pu6lic property <br />Da[e <br />7. 50 �' �z - /a -7s d� � <br />Fee <br />Approved by � � ,uy� � <br />Date Approved � Z � � % � <br />