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�� APPUCA��ION FOR RIGHT-OF-WAY USE PERnnir <br /> �J �.v'J z�� <br /> CITY ENGINEERS � <br /> EVERETT,WASHINGTON PERMIT N0. <br /> The Undersigned._ <br /> Herehy applies for permission to <br /> At the following location <br /> SKETCH - � �--- <br /> (Work to be danc) <br /> i � /k <br /> DRIVEWAY SECTION The undersigned owner hereby ayiees to hold and <br /> _. _ NO SCALE save harmless the Ciry cf Everett from any and all <br /> �' —_----__� <br /> � claims for damages that may arise because of installa� <br /> � Y' Lia —�� tion and maintenance of the improvement hern[o <br /> --� <br /> �3o':.i� i . . I 30"� applicd fnr and further agrees ro remove same upon <br /> notice from the Ciry and to rrplace public property <br /> damaged thereby. <br /> Signature of Applicant <br /> � i;OPY OF THIS APPLICATION�TO � i Address <br /> �� !i�_ POSTED ON JOBSITE. <br /> ! CALL ENGINEERING DEPT. 259-8811 j Telephone Number <br /> , 2•1 HOURS BEFORE CONSTRUCTIOfd i Date - <br /> . . ---�-------- - <br /> CHECK LIST Fee <br /> Wator Valve <br /> Draina9e Dept. Approval5 <br /> Curb&Gutte� Engineers_ <br /> Sidewalk — <br /> Water <br /> Street <br /> ------------- - -- Ccmmunications_ <br /> _ .--------. . <br /> Inspector's Signa[uru <br /> Tnf(ic <br /> Plannin�_ <br /> ._ __.._ - __ _. ____ <br /> Date �--- - �_ . __.. <br /> - -.. _. _ .._ ___ _ _.-__— --- - - <br /> �LI11Jf�:5 <br /> Rpproved by <br /> o��� ai»�o��ed � <br />