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y- <br />ev®rett <br />i <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the following I <br />SKETCH <br />(Work to be done) <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />try ;A�'E <br />DRIVEWAY SECTION <br />NO SCALE <br />+I" LIP <br />30, <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT.25P-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />r f <br />Dale \ <br />Remarks <br />Note: Original to Customer 1 Copy to File 10532 <br />1 Copy t3 Inspector <br />S., �- 0,. <br />10532 <br />PERM;T <br />The undersigned owner hereby agrees to ho!d and <br />save harmless 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 , nd to replace public property <br />damaged thereFy. <br />Signature of Apptican l <br />Address <br />_-_r. . <br />Telephone Number <br />Date / <br />f-ee <br />Dept. Approvals <br />:. <br />Engineers <br />Water,-,�[�gr <br />Street_ - % <br />Approved by ;'1 c <br />Date Approved iJ yr <br />,11 <br />