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C <br />APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br />everet, � � 0 n O � <br />.e � <br />CITY ENGINEERS ��j_ � � <br />EVERETT, WASHINGTON PERMIT NO.�� <br />The Undersigned 1'� Og��T G. Lo v e <br />. <br />Herebyappliesforpermissionto GONST2, t� /� �DU/ %/ON 70 �5(/S? /O � I�UiU� <br />At the following <br />SKETCH <br />(Work to be done) <br />� <br />DRIVEWAY SECTIOnI <br />NO SCALE <br />�-- / o ;q-pt'i.--- - �{ <br />`��� �i� <br />�30�__ __�30" <br />i <br />� COPY OF THIS APPLIC�TION TO <br />BE POSTED ON JOBSITE. � <br />� CALL ENGINEERING D�PT. 259�881 I I; <br />- 24 HOURS BEF09E CONSTRUCTIONI <br />CHECK LIST <br />�, Water Valve —{Z�,'iSc t� fi Il A�e <br />'. Drainage � <br />�., Curb & Gutter <br />� Sidewalk ,�/oNF_ <br />��»-��-� fr - �s- � y��� <br />� Inspector's5igna re <br />"1-3 =7� — <br />2�e <br />Remarks <br />Note: Ori�inal to Cusromer <br />t Copy to File <br />1 Copy to Inspector <br />- �Ec �a <br />No <br />S�A�F <br />The undersigned owner hereby agrees to hold and <br />save harm�ess the City of Everett from any and all <br />claims 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 the City and to replace puhlic property <br />damaged. thereby. <br />� r.���.P�-.�. <br />Sic�nalure of App icant <br />� ! '�, — 5 0 {-`- :a�' . .5 . .E'. <br />Address <br />;;�-;,�_ 4�.;� <br />Telephone Number <br />/ - 't n _ -�Q <br />Date � c�, 7_ �_ y c� <br />>�� /;c� <br />Fee ���� <br />��-�c... Dept. Approvals <br />10�07 - <br />Approved by /� � % <br />Dat Approved ����j,� <br />11 <br />�� <br />