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everetl <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned _ <br />Hereby apPlies for permission to <br />At the following location_ <br />SKETCH <br />(Work ta be donel <br />■ <br />APPLICATION FOR RIGNT•OF•WAY USE PFRMIT <br />� :. l <br />d %+ <br />,� � <br />_: J_„____"�J`_�-��� <br />94 s � <br />DRWEWAV SEC7ION <br />NO SLA�E <br />r <br />_� LIP .—_.— .—_.� _ _J <br />�.30"w ' �y30".. <br />� COPY Oh THIS /�PPIJCl1TION l U <br />'� [3E POSTED ON JOOSITC-. <br />CnLL ENGINEERING DEPT. 259-Afll l <br />� 7M1 HOURS 8[FORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector'sSignature �� <br />bate -' - --- _ _..__.. <br />Remarks <br />11353 <br />PERMIT N0. <br />The under,ic�ned owner hereby agrces to hold and <br />save harmless the Ciry of Everett from any and all <br />claims for dama�es that may arise because of installa� <br />tion and maintenanr,e of the improvement hereto <br />applied for and further agrees to �emove same upon <br />notir.e from Ihe City and to replace pu6�ic property <br />AamaFled thereby. <br />Signalurr. of Applicani <br />Address - � � <br />Telephone Number <br />Dare <br />Dept. Approvals <br />Engineers _ __ <br />Watcr <br />Street _.___ <br />Communicetions <br />Traflic <br />Planning._ <br />AnnfoVed 6y '-_ <br />D.��e Approved �- ���� <br />