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cverett <br />CITY LNGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned �'H�Kd <br />Hereby applies for permission to <br />APPLICATION FOR 1116011-OF-WAY USL PERMIT <br />At the following location <br />r C) <br />SKETCH —" -- - "- <br />(Work to be done) <br />OAIVEWAY SECTION <br />NO SCALE <br />it- IP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOSSITE. <br />CALL ENGINEERING DEPT. 259.8811 <br />24 HOURS BEFORE CONSTRUCTIO . <br />CHECKLIST <br />Water Valve <br />Drainage <br />urb b utter <br />Sidewalk <br />Inspector's Signature <br />-Tiate <br />Remarks ---------- .._-. <br />Note: Original to Customer <br />1 Copy to File 11006 <br />1 Copy to Inspector <br />11006 <br />PERMITNO. 7,~. Z_ <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages Mat may arise because of instelli• <br />tion and maintenatMt of the improvement harelo <br />applied for and further agrees to temnve same upon <br />notice from the City and to replace public properly <br />dam>ad hergby� <br />�` gnalu o Applicant <br />diIirqs <br />cic�ih� <br />Data <br />LLDept: pprpv is <br />Engineers__ C <br />Water <br />Communications <br />Planning _ <br />Approved by <br />