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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> 1 <br /> �^ <br /> cvcrctt 1 016 3 <br /> e <br /> CITY ENGINEERS 75- 47 <br /> EVERETT,WASHINGTON PERMIT NO. <br /> i ' <br /> The Undersigned OO nt_ n <br /> CHereby applies for permission to GDN.57WO07- 326 ' ASPHALT PRIVF_WAY <br /> At the following location S/B — ( Ory 57- - <br /> SKETCH <br /> T -SKETCH <br /> (Work to Fre done) E.D6E DFEX1577NiS <br /> PAVEMENT ZO - <br /> S T <br /> 8, <br /> NEW <br /> A SPFWLT <br /> DRIVEWAY <br /> Cl" <br /> 5/8 Q <br /> -REPLWE EXISTING 2'xZ'WD0A9V � <br /> j /NLE 1- WITH CITY 57;4**ARD /,V/-ET <br /> AID SCALE <br /> I <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> 3s' claims for damages that may arise because of installa- <br /> I„ LIP tion and maintenance of the improvement hereto <br /> applied fora further agrees to remove same upon <br /> t, notice fro he City and to i ce pylstic propert <br /> —w— damaged er by. <br /> 4C <br /> t� Signet o Applicant <br /> �1'\1 Ad&F.$$ <br /> COPY OF THIS APPLICATION TOV�' _._, Z ����„ <br /> BE POSTED ON JOBSITE. '�^\ <br /> Telephone Number <br /> CALL ENGINEERING DEPT. 25&8811 3� r/— 2 6- a? <br /> 124 HO R BEFORE CONSTRUCTI� Date / /'; <br /> CHECkLIST !> ' Fee <br /> Water Valva N D pt. Approvals <br /> Drainage <br /> Curb Be Gutter S / Engineers <br /> SidewalkI'� I�� � 1• Water <br /> Street4. <br /> I( _�iS NULLl f �t0� Communications <br /> Inspector's Signature �tl�. 0- Traffic <br /> rxI i(4 c� Ring <br /> - <br /> bate <br /> Gln I lLa!/=1'ik rr ( <br /> Remarks ' <br /> Note: Original to �Customer <br /> 1 Copy to File 10163 dd�11'',, ./ <br /> 1 Copy to Inspector App v 7(� /.�a1G� 7 Y-/,r <br /> � f <br /> Date Appro ad <br />