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everett <br />e <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />11098 <br />CITY ENGINEERS 7 <br />EVERETT, WASHINGTON PERMIT N0. � � - = <br />The Undersigned i��) r=� !� T i- r� 1 � ��� r � NC . <br />Hereby applies for permission to _ �� - � • � — ,r� / ,„ �J,_ � ` ; �„ ; � �-1 � ,, .,.., <br />� : r� __� /f . �'�t. . v , r.. ,. /.�. .�. , <br />At the following <br />SKETCH <br />(Work to be done) <br />ORIVEWAY SECTION <br />NO SCALE <br />� � <br />I" LIP <br />30" __�30" I <br />— '1 <br />COPY OF THIS APPLICATION TO � <br />BE POSTED ON JOBSITE. i <br />CALL ENGINE-ERING DEPT. 259-Bi377 <br />24 HOURS BEFORE CONSTRUCTIONI <br />S� I ��:' � <br />ate <br />Remarks <br />Note: Original to Customer <br />1 Copy to File <br />1 Copy to Inspector <br />y 7 7 i=i ,. i 1.: �� � <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />c�aims 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 public property <br />damaged thereby. <br />� /- i,-n/ �i cr li <br />Signature of Applicant <br />� ��, , -,/'%! / ./ <br />Address . %.. C,. ,(r <br />/ � / %/'/ <br />Telephone Number <br />1 /(� � �J� <br />Date <br />Fee <br />y: <br />_j�Pt. APP� Sls. , r <br />� �� `� � I' <br />Engin�eEz i==� 1 � 1� I �l 1-.! 11-! C <br />Communicetions <br />1"1�9$ '� <br />ApProved.�y � � Tj i � ___/ <br />�1.+ �.) �C <br />— �� <br />DateApproved ?- (',- 7<g' <br />