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. _ . , <br /> r'verett APPLICATION FOR RIGHT-OF-WAY USE PERMIT � <br /> � I^I 1 I <br /> i <br /> i, <br /> CITY ENGINEcRS � <br /> EVERETT, WASHINGTON , <br /> PERMIT N0. <br /> The Undersigned � ' � - - ' <br /> Hereby applies for permission to , �� <br /> + i <br /> At the following location , <br /> — , <br /> SKETCH <br /> (Work m be donel <br /> ._ � 1. �,,..' - �i`�Z�: . <br /> ..� �_- r �,"/ <br /> , ;J� �� �,: <br /> i <br /> I'1 DRIVEWAY SECTION <br /> I NO SCALE The undersigned owner hereby agrees to hold and <br /> � save harmless the Ciry of Everett trom any and all <br /> claims for damages that may arise because of installa� <br /> � i�" LIP tion and maintenancr. of the improvement hereto <br /> � 30" I g�•� � applied for and further agrees ro remove same upon <br /> � ��' , � notice from [he City and to repiace public property <br /> ' damaged thereby. <br /> Signature of Applicant <br /> COPY OF THIS APPLICATION TO ' Address <br /> BE POSTED ON JOBSITE � - � . <br /> CALL ENGINEERING DEPT. 259-8871 Telephone Number <br /> 24 HOURS BEFORE CONSTRUCTION � � Date <br /> CHECK LIST Fee <br />� Water Valve .� <br /> Drainaqe Dept. Approvals <br /> hCurb & Gutter Engineers_ <br /> Sidewalk <br /> Water <br /> /i� Street <br /> Inspector's5ign ure Communications_ <br />, �� � Traffic � <br /> � f Planning <br /> ate <br /> �� <br /> Remarks <br /> 1.130 '�� <br /> Ii Approved by . , . . <br /> �-_,.�� <br /> If�;.P;.C��G£ �'n;-�... DateApproved , 3 <br />