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APPLICATION FOR RIGHT-OF-WAY USE PER1011 <br />W <br />10619 <br />CITY ENGINEERS <br />EVERETT, WASHINGTON PERMIT NO.26 — 2 7 $' <br />The Undersigned J. v i, hq r41 r,0 '' <br />Hereby applies for perm fit Ion to r' � t /t ?S' A nh att wv - <br />At the following location / S.20 i <C/ V P/ S. r <br />(Work to be done( <br />V,/ I— w —y_ou. V/._ <br />Mole: SerVILr% S <br />►lair as Stiau�d <br />�acaEed / ro <br />P azac i, ;� ! <br />DRIVEWAY SECTION <br />NO SCALE <br />+I" LIP <br />I aDl 70.E <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 & Guttor <br />Sidewalk <br />14J <br />Inspector's igna Mu re <br />a - <br />Remarks <br />Note: Original to Customer 1 Copy to File 10619 <br />1 Copy to Inspector <br />/ — Th rds t 9 /e e K <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from 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 some upon <br />notice from the City and to replace public property <br />damaged thereby. <br />Signature o pp cant <br />Address <br />Telephone Number <br />Date <br />Fee , JJ <br />^Dept. Appr 3 j III <br />Communi.ationt <br />Traffic <br />Planning <br />? 4 <br />Stlu�tl _�G TsimµAps <br />.� l� 1. <br />Datt Ap roved <br />v <br />