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�. . I <br />� !\PPLiCA. fiON i OR RIGHT•OF-WAY USE PERMIT <br /> I • � everelt �_ '�_ .' �'' `, <br /> II � . <br />� CITYENGINEEFS pERMITN0. -- <br /> I EVERETT, WASHINGTON <br />� The Undersi9ned , <br /> Hereby applies for permission to . � � � <br /> At the follotving location _ <br /> SKETCH ` <br /> (Work to be done) <br /> # <br /> ORIVEWAY SECTION The undersi9ned owner hereby a9rees to hold and <br /> save harmless the City of Evecett`rom any and all <br /> ❑0 SCALE <br /> ___ __� claims for damages that may arise because of installa� <br /> � tion and maintenance of the improvement heretu <br /> t' LIP applied for and further agrees to remove same upon <br /> �30'�„__. _—_.�3� notice from the Ciry and to replace public property <br /> --- �� damaged thereby. , <br /> Signature of Applicant � � �� <br /> . _-----------.. .------ Address . . <br /> � . <br /> �- — — <br /> ICOPY OF THIS APPLIf.ATIOtJ TO - . <br /> E3r- pOSTED ON J06SITE. Telephone Number <br /> � CALL ENGINEERING DEPT. 259�6811 Date �� <br /> ?1 NOURS 6EFORE- CONSTf:UCTION <br /> � - - -�— --- Fee <br /> CHECK LIST Dept. Approvals <br /> Water Valve <br /> Drainage . Engineers _— <br /> Curb & Gutter . � � � <br /> Sidew�lk Water - <br /> Street <br /> Ccmmunications - '-�� <br /> Inspector' Signa rc Traffic <br /> Planning <br /> ��e �., ` �I � � — <br /> J <br /> Remarks <br /> 1, .i ,� 0 �r <br /> APProved 6Y � . :i � --- <br /> . _ ..�;,-;� "i . �`�:�,%�'i <br /> Da[e Approved � ' 3 <br /> INSPECTOR'S CPPY' '��7�� - <br /> ] <br />