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W- <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned <br />Hereby applies fo <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />At the following location -A -j ' u p mfz R l bGE R'D . <br />0037 <br />PEDIVIT NO. 74 — 4V <br />(Work to be don <br />m <br />.•� / / �..t LAC CAJI AIT <br />DRIVEWAY SECTION <br />NO SCALE <br />I \ 11LIP I <br />i-3o-+- ____-—l-30•_J <br />COPY OF THIS APPLICATION -i 0 <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 25 <br />9 <br />8811 <br />24 YOURS P.EFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter ' <br />Sidewalk <br />Inspector's Signature <br />II''-- �!i <br />at — <br />Remarks <br />Note: Original to Customer <br />ICopy toFile 10037 <br />1 Copy to Inspector <br />435t <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 same upon <br />notice from the City and to replace public property <br />damaged ereby. <br />-9�ig—nkGrli of Applicay a !..�t—/i7 <br />Address <br />Telephonesumber <br />Date <br />►�. so s�An o.:,.�y <br />Fee <br />_ . , Dent. Anorovals <br />Approved by f'J <br />Date Approved <br />