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ki <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10498�r�' <br />PERMIT NO 74— <br />The Undersigned J a m e$ C a A n r j _ <br />Hereby applies for permission to ConCtr,.r'F a /� S� Aj.pj D AW on L^. f.. R• e9' tU <br />At the following location -t LS'- h L --i ! 0 S T <br />SKETCH <br />(Work to be done) <br />\\ to Mar <br />7-o 6,c Ne3/avUOn/EOz_ <br />I I CTi i •� <br />K <br />Ala 5cnIP <br />- R°. <br />617126 <br />DRIVEWAY SECTION <br />NO SCALE <br />� - 47 — '1 <br />1" LIP <br />4rf� r <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 2598811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />n rreI's <br />/13"-7 (r <br />Date <br />L <br />4 IO - F--f <br />X- I I PI/I <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 Installs <br />lion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notes�{{ from the City and to replace public property <br />d mailed thereby. s- <br />Signature-of Applicant. ! — <br />Address <br />Telephone Number <br />Date <br />Fee <br />apt. pp o Is 6 <br />Engineer J <br />Water — - r+. <br />Streetf' <br />Communications <br />Traffic t / <br />Planning J rLLLC11-1'.1L7[i <br />1G <br />SQ r .i a e . Al C 2!4O .Asp dt 11c�r( %r<l <br />Remarks <br />Note: Original to Customer <br />1 Copy to File i. n 4 9 g Approved by t% <br />1 Copy to Inspector 76 <br />it <br />Date Approved <br />