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ki <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned C... �- <br />Hereby applies for permission to <br />APPLICATION FOR RI,13 i-OF-WAY USE PERMIT <br />At the following location_ <br />(Work to be done) <br />i <br />DRIVEWAY SECTION <br />NO SCALE <br />I \ fI" LIP <br />M <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT.259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECKLIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />ate <br />Remarks <br />Note: Original to Customer <br />SQL. <br />1.0459 <br />PERMIT NO. 76 — 4J'3 <br />The undersigned owner hereby agrees to hold 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 and to replace public property <br />damaged thereby. <br />qin atu`hi ra of Annlirant'= <br />ICopy toFile 10459 I� <br />1 Copy to Inspector APpro`redlbyY /olv <br />Date Approved <br />