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everctt <br />�e <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10841 <br />PERMIT NO. 7 7 - Pf!g <br />The Undersigned --F 5170 UZV I K U iZ <br />Hereby applies for permission to 1" 2 d/ S j Rt/f _- /-f / i d 5t>dAL i <br />At the following location <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />�-- t� I" LIP I <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT, 2596811I <br />124 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Watsr Valve <br />Drainage <br />Curb E Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10841 <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 />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove some upon <br />notice from tbrCity and to,,tpj#ace pbbpc property <br />Add <br />Xxvpc 7 . 09 /ao l <br />Fee <br />Dept. Approval <br />Approvals <br />Engineers . 16��- _.i_•i <br />Communications <br />Approved by <br />Date Approved <br />