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- APPLICATION FOR RIGHT-OF-WAY USE PERMIT � � �4 H <br /> � everett <br /> � e <br /> ' CITY LNGINEERS � <br /> EVERETT, WASHINGTON PERMIT NQ � - � <br /> The Undersigned <br /> Hereby applies for permission to _ �� <br /> At the following location � � - � � � � � � <br /> SKETCH <br /> (Work to be done) <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> � --�-� "-�---�j claims for damagss that may arise because of installa� <br /> �I" LIP �� tion and maintenance of [he improvement hereto <br /> , applied for and furlher a9rees to remove same upon <br /> � 30'�_., . I 30' I . <br /> i- ----•fi� --1 notice from the City and to replace public properry <br /> damaged Ihereby, � <br /> Signature of Applicant <br /> _. . _ ._. ___- .. . . . ._ .. __. � � .- . �. <br /> COPY 0(= TI-IIS l�PPI_ICr,�IOfJ TO I Address � . - � � <br /> RE POSTED ON JOQSITE. � Telephone Number <br /> i CALL ENGINE[RING DEPT. 2.�&8811 I �� _ <br /> 24 HOIIRS BFFORE CGNSTRUCTIO"•ii Date <br /> I__ ..___----------__. __. _. ._. <br /> CHECK LIST Fee - <br /> Water vaive Dept. Approvals <br /> Drainage <br /> Curb &Gutter En9ineers <br /> Sidewalk <br /> Water <br /> , Stree[ <br /> � � Communications <br /> Ins c ' Signature <br /> Traffic <br /> � fo,J �L — / C` � C� Planning <br /> � _� /\ _ J __'J <br /> ate <br /> _ � — <br /> Remarks ---' ' <br /> J i <br /> Approved by <br /> ,. . Date Approved 3 <br /> . . � ,..,i,-.. . . <br />