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ki <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMI- <br />10499 <br />PERMIT NO, <br />The Undersigned o n-) t• C� n n P .. <br />Hereby applies for permission to con ' i L.Lf t 2 S A K f' h L Al MM C <br />At the following location 1 40 G A_O S7-, S . C . <br />SKETCH <br />(Work to be done) <br />,t5,Y/ST/NG ///W97%-,e <br />ScdY/Ct TG/3E q�y�E� <br />No Scn le <br />DRIVEWAY SECTION <br />(� NO SCALE <br />41- LP <br />43 <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 />Ins tort Sig�ure <br />l <br />att <br />Fair 1:nq 12... <br />Is,/3 <br />A'3 <br />rx;�f:oi C,0,46 <br />Sew <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 />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />noti�e from the City apd to replace public property <br />damaged thereby. -i <br />t i <br />Ignature of Applicant <br />Address <br />Telephone Number <br />Date <br />Fee � <br />Note: Original to Customer <br />I Copy to File 10499 <br />1 Copy to Inspector A�PPr�oved�by <br />Date Ap oved fJ <br />