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APPLICATION FOR RICHT-OF-WAY USE PERMIT <br /> eVCfC" 10 616 <br /> e <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON // PERMIT NO. 2 - 13 3 <br /> The Undersigned <br /> Here'b'y applies for permission to G- Lo,. l�s•"s � �1b,C <br /> At the folio wing location 5TKIEE5C <br /> SKETCH <br /> (Work to be dont; <br /> S S t-1.hisle <br /> S t. <br /> � a <br /> PIL-ir 7 .rnrs(r 7 j�4 Ga/v <br /> ( <br /> a00 <br /> / I <br /> rV 4�� GaY <br /> W <br /> LA 5 Y St• <br /> I <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the Cits of Everett from any and all ' <br /> �- - --� claims for damages that may arise because of Installa- <br /> t" LIP _�l tion and maintenance of the improvement hereto <br /> applied for and further agrees to remove same upon <br /> 30 notice from the City and to re Ince public property <br /> demi th,reby/�-�-�'�++ <br /> (jAddress <br /> pplicant <br /> COPY OF THIS APPLICATION TO BE POSTED ON JOBSITE.CALL ENGINEERING DEPT,2598811mber 9 <br /> 24 HOURS BEFORE CONSTRUCTION Date 3 <br /> CHECK LIST Fee NG <br /> Water Valve Dept. Approvals <br /> Drainage <br /> Curb&Gutter Engineers <br /> Sidewalk Water.9 Vo.,, �lr Me etScv o ��� <br /> ,P .ver vis r. „ a ;,: r•dnn,.„,r Street Ci <br /> Communications - — <br /> Inspector's Signature Traffic— <br /> , Planning <br /> Date <br /> Remarks <br /> Note: Original to Customer <br /> 1 Copy to File 1 n 6 11 6 <br /> ;1 Copy to Inspector Approved by <br /> Date Approved Ij <br />