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APPLICATION FOR 11IGHT•OF•WAY USE PERMIT <br /> t•vrn•II <br /> CITY FNGINCERS <br /> EVERETT,WASHINGTON PF:IIMITIIO._�_�� L� <br /> The Undersigned OC7L /y//y <br /> Hereby applies for permission to <br /> At [Ito fl' n•.inp location-3-17 771 rf p1. S, W, <br /> (ylork lobe done! <br /> i6pp7 <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any anflall--� <br /> ---— —"I claims for dam gas that may arise because'of installa• <br /> �=�s I" LOP tion and maint ante of the-im rovement hereto <br /> applied for at1d <br /> es o Qve same upon <br /> notice freplace pablic property <br /> ;I ^ Signature Cof` —M v <br /> I � w <br /> COPY OF THIS APPLICATION TOO A dress <br /> RE POSTED ON JOBSITE. <br /> ph <br /> CALL ENGINEERING DEPT.759.8811 _ Tc 7 ne Num <br /> GIT : �= 1"': Date <br /> CHECK <br /> d L3 <br /> 74 HOURS BEFORE CONSTRUCTION L 0� UL <br /> CHECK LIST Fee <br /> Wwor Valve <br /> Drainage <br /> Dept. Approvals <br /> Curb F Gutter Engineers_ <br /> Sidewalk Water <br /> Street <br /> Communications <br /> Inspector's Signature Traffic _— <br /> Planning <br /> 'bate <br /> Remarks <br /> Approved by <br />