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^veretl <br />e <br />CITY ENGINEERS <br />EVEHETi, WASHINGTOtJ <br />The Underslgned _ <br />Hereby applies for permission to <br />At the lullowing Iceation. <br />SKETCH <br />(Work ro be done) <br />APPLICATION FOR RIGHT•OF-WAY USE PERM!T <br />DRWEWAY SECTION <br />NO SC4LE <br />r- - .1 <br />�- �=�'--_->> <br />�JD.y �_—_-- µ30"� <br />� I;QPY OF 7H15l1PPLICn11UfJ lU <br />I BE POSTED ON JOBSITG. <br />' CALL ENGINE[RIN(; DEPT. 7Ci9 flNl l <br />� 74 �10UflS F3CFpRE f.ONS1 RUCTIONi <br />CHECK LIST <br />Water Valve <br />Drainege <br />Curb & Gutter <br />Sidewalk <br />_..---- - . ._. _. . .._..._. <br />Immpector's Signature <br />bate <br />nnrks <br />PERMIT N0.._ <br />The undersigned owner hereby ag�ees [o hold end <br />save harmless tha Ciry of Everelt from eny and all <br />cl;,ims for damaqes Ihat may erise because of (nttdl�� <br />tion and rnainte.nance ot ihe improvement hereto <br />apPlied for and further egrees m remove same upon <br />notice I�om the City and to replace publie property <br />Aamaged theieby. <br />Signa�ure ol Applican[ <br />Address <br />Telephone Number <br />Date — <br />ree <br />Dept. Approvals <br />Engineers____ _ <br />Water <br />S�reei <br />Cammunications <br />Traffic <br />Planning _ _ <br />Approved by <br />Date Approved <br />