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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />everett ;"`' <br />CITY ENGINEERS <br />EVERETT, WASH INGTON <br />The Undersigned L_ IN <br />Hereby applies for permission to <br />At the <br />(Work to be done) <br />L AVbSCAPINC <br />PP RA W <br />? 70 2 <br />LPMELVI <br />PLBOE MIN.1Z" DIA <br />C,UL VERT <br />EDGE OF EXISTING RURa <br />DRIVEWAY SECTION <br />NO S ALE <br />I' LIP <br />MIN 4, <br />ti <br />n <br />2 <br />TZ <br />lE <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE <br />CALL ENGINEERING DEPT.259.881T �'�'� BY LUf/ 1� <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb &Gutter <br />Sidewalk <br />Inspector's Signature <br />D 7 L �\ <br />Remarks <br />Note: Original to Customer <br />1 Copy to File <br />1 Copy to Inspector <br />10282 <br />PERMIT NO. — <br />PLACE M//Y. / 2 ° D/A <br />,CONCRETE O ULVLer <br />Nildl pKIU�lAlAlr' <br />dui LA.ND�!'Af'IrUI= <br />-30.1 /too .SL91.f> <br />-io' <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 />79y..�a83 � �sti�-:tii Sti <br />Date <br />,0, r";ii �• ��%�fi7i�7) � <br />Fee <br />1.n2g2 APpr <br />Data Appro ed ' <br />