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�veretl <br />� <br />CITY ENGINEERS <br />EVEREI'T. WASHINGTON <br />The Undersigned _ � � � <br />HercSy applies for permission to <br />At the following location <br />(Work to 6e done) <br />APi�LICATION FOR RIGHT-OF•WHIr USE PERMIT <br />DRIVEWAY SECTION <br />NO SCALE _� <br />l.-- — -- <br />I <br />I" LIP <br />�30��_ _ _ 30 <br />I <br />COPY OF �i HIS APPLICATION TO <br />BE POST[D �N JOBSITE. <br />CALL ENGINEERING DEPT. 159�8811 <br />24 HOURS BEFORE I:ONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />� .1_�:;�� <br />PERMIT <br />1 1230 <br />% - <br />, .�-r��.;�.s� <br />The undersigned owner hereby agrees to hold and <br />save harmless the Ciry of Everett from any and all <br />claims for damages that maY arise because of installa� <br />tion and maintenance of tY�e improvemen[ hereto <br />�pplied for and further a9rees to remove same upon <br />nolice from the Ciry and to replace public property <br />damaged thereby. . <br />SignaWre of Applicant <br />Address <br />TeleFlhone Number <br />Date <br />Dept. Approvals <br />S+ <br />, <br />Approved by <br />� <br />I�ILt= l:Ui"! <br />Date Approved <br />