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��,.�,�. <br /> . 1 <br /> APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> everetl � <br /> � � `���� <br /> NN � <br /> �I <br /> CITY ENGINFFa: <br /> � <br /> EVERETT, WASHINGTON PERMIT N0.___ ; <br /> ?>>e Undersigned ___ ___ _ <br /> Hereby applies for permisr��.�;. :c� ____ ___ � ' <br /> At the following location <br /> SKETCH <br /> 1�Vork to be done� ' <br /> CRIVEWAY SECTIO�Y The undersigncd owner hereby agrees to holo and <br /> {� NO SCaLE save harmless ihe City of Everett (rom any and all <br /> I � � �� claims for damages that may arise because of ins[alla� <br /> L �_ip —� tion and maintenance of the improvement hereto <br /> �j� � —I - w3�..� epplied for and further a9rees to remove same upon <br /> � notice from the City and ro replace public property <br /> damaged [hereby. <br /> Signature of Applicant �- <br /> 'I COPY OF THIS P.PPLICATION TO �� Address <br /> ElE POSTCD ON JOBSITE. I <br /> � CALL ENGINE[RING DEPT. 259-h811 Telephone Number <br /> 24 HOURS BEFORE CONSTRUCTION Date <br /> CHECK LIST Fee �-- <br /> LWater Valve <br /> uraina9e Dept. Appro�als <br /> Curb&Gu'ter Engineers <br /> Sidewalk <br /> Water <br /> Street <br /> ---- -----_.-—_ .. _._ __ . Cnmmunications. / � <br /> Intipector'sSignaturc- -�--�--- -1+• � <br /> Traffic /,�7� (I��/1 <br /> V <br /> Planriing —q�---+1U � <br /> Datc . _._ ....._ .------ ------ '"c 7 � <br /> -----f/r'�j--��°, <br /> v� 2 <br /> ._ __._ _.. . _ _.. <br /> P.emarks � <br /> Approved 6y / <br /> i <br /> -- ' <br /> Date F.pprrn�ad ;----� 7 <br /> % �� <br />