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APPLICATION FOR RIGHT-OF-WAY USE PERMIT _09n ^ 2 <br /> cv� J� 42 <br /> CITY ENGINEERS 7 41 r <br /> EVERETT,WASHINGTON <br /> PER111TN0.__The Undersigned /' .,—T .- ------------- --- — <br /> Hereby applies for permission to r — — <br /> At the following location <br /> SKETCH <br /> (Work to be done) <br /> i <br /> t <br /> 1 <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> (..�NO SCALE---- save harmless the City of Everett from any end all <br /> claims for damages that may arise because of installa- <br /> f 1 LIP �� tion and maintenance of the improvement hereto <br /> applied for and further agrees to remove same upon <br /> notice from th City and to r place p�bl' property <br /> dayaged-tF by <br /> ti <br /> Sign r of p ant <br /> COPY OF OF THIS APPI ATION TO Addr s <br /> K <br /> BE POSTED ON JOBSITE. um <br /> Telephone Number <br /> r�. <br /> CALL ENGINEERING DEPT. 2588811 fT/'//�J77 - <br /> 24 HOURS BEFORE CONSTRUCTION Date 'ems r- <br /> I — <br /> CHECK LIST Fee <br /> Water Valve Dept. Approvals <br /> Drainageineers En <br /> Curb&Gutter '.t r/>7, rJ ,'/':y,,`,•, ��,?'.{ 9 .Er-'•' - -- <br /> Sidewalk /% Water <br /> Street----- <br /> Communications-- <br /> Inspector's <br /> treet _ — <br /> Communications - <br /> Inspector'sSignaturo Traffic --- - <br /> Planning --- <br /> ate <br /> Remarks <br /> Nnte: Original to Customer — <br /> ' 1 Copy to File 1. O J 4 2 Approvsd by <br /> 1 Copy to Inspector <br /> Date Approved <br />