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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />rs on•tl <br />CITY ENGINEERS <br />EVERETT, WASHINGTON PERMIT NO <br />The Undersigned '. /a l: ,'/ ,_ -- - <br />Hereby applies for permission to ..., - <br />At the following location <br />SKETCH — <br />(Work to be done) <br />DRIVEWAY SECTION <br />. NO SCALE <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECKLIST <br />Wator Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk I j /I e PA'I, ( A/ I- r <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />i Copy to File <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 same upon <br />notice from the City and to replace public property <br />damaged thereby. <br />,J I <br />Signature of Applic nt f -' <br />/ L5 <br />Address 0 r <br />i )r' f/ 7 k <br />Telephone umher <br />Date <br />Dept. Approvals <br />Engineers—, <br />Engineers fr' , <br />Water <br />Street <br />Communications <br />Traffic_ <br />Planning <br />Approved by <br />Date Approved <br />