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WAPPI'CATION FOR RIGHT-OF-WAY USE Pr -MIT 10922 <br />CITY ENGINEERS <br />PERMIT N0. <br />EVERETT. WASHINGTON _L <br />The Undersigned ildRc)L 5'/�a,�nii��v✓ <br />Hereby applies for permission to rQ^15a6jCr ra <br />At the following location 2-s;17 sr _— <br />(Work to be done) <br />DRIVEWAY SECTION <br />{� NO .:CASE <br />tl" LIP _-- <br />0__ 30.E <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 & utter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer n r, <br />1 Copy to File 1 r `1 <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 installs <br />lion and maintenance of the improvement hereto <br />applied for en u� r agr s to remove same upon <br />notice from a Cit a replace' hlic property <br />,de age ereby/1 <br />S' re licent <br />>L /9�7 itrr� <br />Ad Zell <br />Telephone u mber 1. 7 7 <br />Date <br />wi " <br />Fee <br />Dept. Approvals <br />Engineers ;� <br />.— <br />Communications— <br />Traffic— <br />Planning— <br />Approved by <br />Date Approved <br />