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cvcrclt <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned L -I LAi <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />E <br />At the following location 2 S622) — 7.4 T1 <br />10270 <br />PERMIT N0-75- 1 4FC.0 <br />SKhTGH <br />(Work to be done) EIXE OF EXl5Tllry <br />P4VEMEAI T <br />/D <br />74 T" ST. -- <br />) <br />I <br />5062 NE W ASPHALT <br />DRIVEWAY <br />�T Q <br />Q <br />4 <br />S <br />I <br />I <br />NJ SCAL�RIVEWAv SECTION I The undersigned owner hereby agrees to hold and <br />N0 SCALE _ � I save harmless the City of Everett from any and all it <br />claims for damages that may arise because of installa <br />I" LIP tion and maintenance of the improvement hereto <br />r �) ; ; ( applied for and further agrees to remove same upon <br />k30', _ 30' I nofjcl�frorrythe City and to replace public property <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOSSITE, <br />CALL ENGINEERING DEPT. 2598811 <br />24 HOURS BEFORE CONSTRUCTION <br />-2 - % �o <br />ate <br />Remarks <br />Note: Original to Customer <br />ICopytoFile 10270 <br />1 Copy to Inspector <br />h9 Y0 5 % it l%VC . kVixr-77 <br />pLOddress <br />3575'- <br />Telephone Number <br />� 2.1� Date 9 30 —=�- <br />9- //, 60 3GJj <br />Dept. Approvals <br />Approved by <br />Date Appro A � <br />/'O/// 7Y-- <br />