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..s <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />e� 10360 <br />CITY ENGINEERS PERMIT NO. <br />EVERETT,WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the fo. wing location <br />i <br />SKETCH <br />(Work to be done) Gr/Gi�E2% / O <br />EfE SGc�D <br />1 - - <br />,-fY <br />v� <br />N5� ALL /5' Gc/LVERi <br />/NSTALL CONSJ' 9SPNALT qW <br />j <br />EX/5Tl:V6 15CoeVtFe/ <br />DRIVEWAY SECTION <br />NO SCALE <br />I'r LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />4626 <br />Remarks` r.� i,% /��/i(/G `i/✓/. <br />Note: Original to Customer <br />ICopy toFile 10360 <br />1 Copy to Inspector <br />The undersigned owner hereby agrees to hold and <br />save harmless the City ofEverettfrom 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 />Signature of Applicant <br />Address <br />Telephone Number <br />/- : - 74. <br />Date 7J //7T�7fo <br />Fee <br />Approveo bb Z' - / <br />Date Approves. tJ _ <br />