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rclt <br />L <br />AlY I NGINrLRS <br />:VIRLTT,N'ASH INGTON <br />rho Undarsigned JYAirYA:._— <br />fereby applies for permission to <br />1t the following location_, <br />METCH <br />Work to be done) <br />APPLICATION FOR RIGHT -Or -WAY USE PERMIT <br />10841 <br />1 <br />lye <br />�'o,,es <br />PERMIT NO. `77— I -/3— <br />200¢ 717f42 �� r •�� ��� 40,2i °dam° <br />does 12-0 76 f�'0 <br />7i <br />DRIVEWAY SECTION <br />NO SCALE <br />1 <br />r 11" LIP <br />:OPY OF THIS APPLICATION TO <br />3E POSTED ON JOBSITE. <br />;ALL ENGINEERING DEPT. 259.8811 <br />14 HOURS BEFORE CONSTRUCTION <br />;HECK LIST <br />Nater Valve <br />7raina e <br />urb &Gutter ' <br />sidewalk <br />nspectof's Signature <br />lemarks <br />Jute: Original to Customer 10841 <br />1 Copy to File <br />1 Copy to Inspector <br />The undersigned owner heraby 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 />�noti�ce (prom n' 6ty^and/tQj' lace pti/h7[�Mc property. <br />avgnacu . q� ✓+� %C 7 �4 7 / a ZU 3 <br />Ad Itsa <br />�vL1h/. <br />Fee D pt°Approvals <br />,.V ` <br />Engincen� <br />Water <br />Communications <br />Planning <br />Approved by <br />Date Approved <br />