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APPLICA00NFOR RIGHT-OF-WAYUSEPERMIT- 0942 <br /> e{\v��njr�t�l <br /> `Cpr _ is jM1'?•?' 7 1 <br /> CITY ENGINEERS /1-4/ <br /> tVERETT,WASHINGTON <br /> ERMIT N0._�__ <br /> the Undersigned <br /> Hereby applies for permission to r0 /!=, T /a /7' <br /> At the following location- 3 0 71, 1L PL <br /> SKETCH <br /> (Work to be done) <br /> SE% �AcNEV <br /> OiG �� GGJfdffUG7%61'y�'�' // <br /> I <br /> DRIVEWAY SECTIC4 The undersigned owner hereby agrees to hold and <br /> {�NO SCALE tare harmless the City of Everett from any and st <br /> 1 J claims for damages that may arise because of inalla• <br /> tion and ma'ntenance of the improvement hereto <br /> LIP applied}or and further agrees to remove same upon ' <br /> �e I 70" *ss <br /> y and to r place ppbrc property <br /> da by. <br /> ant <br /> ✓�-'YF <br /> COPY OF THIS APPLICATION TO el el <br /> BE POSTED ON JOBSITE. elephone Numhery //' / <br /> CALL ENGINEERING DEPT.259 8811 Date <br /> ?� <br /> 24 HOURS BEFORE CONSTRUCTION Dau I/Qso <br /> Fee <br /> CHECK LIST <br /> Water Valve Dept. Approvals <br /> Drainage Engineers- <br /> Curb&Gutter <br /> ,^�it:ewalk Water <br /> Street <br /> Communications <br /> Inspector's Signature Traffic <br /> i <br /> Planning <br /> Date <br /> Remarks <br /> Note: Original to Customer <br /> 1 Copy Io 10 0 4 2 F+le Approved by <br /> 1 Copy to Insln•ctm <br /> Date Ahpiovrd <br />