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11 <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned _� I d , f a �1 <br />Hereby applies for permission to s <br />At the following location <br />SKETCH <br />(Work to be done( <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />DRIVEWAY SECTION <br />NO SCALE <br />t I" LIP / 1I <br />ff <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259 8811 <br />24 HOUR;; BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Date <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 1 � 24 2 <br />1 Copy to hrspectol <br />10842 <br />iy-7 <br />PERMIT NO. �% % <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 remo a some upon <br />noti m City nd to ce pu�li property <br />malted reby, <br />gn r o ant <br />% �✓ c f� <br />AddAss <br />Telephone r_ 7 <br />Date C <br />Fee <br />Dept. Approvals <br />Engineers ��% - <br />Street _ <br />Planning <br />Approved by <br />Date Approved <br />