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W <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10493�,� .v <br />tr <br />PERMIT NO. 76 - / /8 <br />The Undersigned W o re IL R c- v a{ r <br />Hereby applies for permission to _ [ on S r rel c 1 a r 5 ' i1 s o h n/w s: f�lr ANO <br />At the following location $/9 - e- / Er r S . t; , <br />(Work to be done) <br />f <br />Sf9 <br />r try <br />? Proper drglriogc <br />0 <br />r / To be Prov;clGil, <br />a / <br />c <br />Eu]1in9 [.a. W newC,6 / {� J„y VACAT[p <br />nnnnd <br />f`uALL <br />L _-84✓ --- — — — --- -- —7-- —� — — RA,v <br />VAL.ATL C <br />NO Scale <br />-eri l/T/Ta <br />DRIVEWAY SECTION <br />NO SCALE <br />f 1" LIP <br />/ I <br />'t72 it <br />J <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE, <br />CALL ENGINEERING DEPT. 259 8811 <br />24 HOURS BEFORE_ CONSTRUCTION] <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />I Copy to File 10493 <br />1 Copy to Inspector <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of Installa• <br />lion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City andL replace public property <br />Date <br />Fee <br />De t on v s <br />Engineer 6 / <br />Weter �. Y iMJ <br />Street , <br />Communications <br />Traffic <br />Planning / <br />Sewer <br />Approve <br />Date Approved <br />