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f <br />� APPLICATION FUR RIGHT-OF-WAY USE PERDIIIT <br /> �iverMt �� � <br />�I <br /> i <br /> � <br /> I ' e - <br /> CITY ENGIN�.F.RS PERMIT NO. <br /> EVERETT, WASHINGTON <br /> The Undersigned___- - �� � � - � � <br /> Hereby applies for permi,sior. to � -� � - <br /> At the following location ` . , � . __ � � <br /> SKETCH <br /> (Work to be done) <br /> The undersigned owner hereby agrees to hold and <br /> DRIVEWAY SECTION save harmless the City of Everett from any and all <br /> NO SCa�E_ __ _� claims for damages that may arise because of installa <br /> �— tion and maintenance of the improvemen[hereto <br /> ;f' LIP applied for and further agrees[o remove same upon <br /> ��--`- 30�� notice from the City and to replace public property <br /> �-.�-�- --- �- - -----�--� damagedtherebY. <br /> Signature of ApP��canY � � <br /> _ -- Address � � �� <br /> i- -� --- - �- -. . __ I . . <br /> � L'OPY OF THIS APPLICAI IOPI l0 Telephone Number <br /> i f3[ POSTED ON JOBSITE. _ _ <br /> �� CnLL ENGINEERING DEPT. 259�8811 Date �. � �� �� `� ��� <br /> 24 HOURS 6EFORE CONSTRUCTION —_—--- <br /> .._.—------ Fce <br /> CHECK LIST Dept. Approvals <br /> yp��er Valve <br /> Drainage Engineers — ---�- <br /> Curb&Gutter ,,,yyy Water - <br /> Sidewalk /r/�l _ <br /> - I Street <br /> vl Communications <br /> Inspector's Sign /- I Traffic = <br /> (\ J Planning _ <br /> � �� <br /> � - <br /> ate � � _ <br /> y -- <br /> Remarks --- <br /> .� ,� � -r ��� _ - <br /> Anproved by . <br /> --- --- ----, <br /> Date Approved � <br /> � <br />