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i <br />evgyetl <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned :Jf ya <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />COPY OI- THIS APPLICAT ION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 258 8811 <br />24 HOURS BEFORE CONSTRICTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & utter <br />Sidowalk <br />Inspector's Signature <br />_Uete <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 11007 <br />1 Copy to Inspector <br />11007 <br />PERMIT NO. 3 1 — ��1 <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 thereby. _ _ <br />Signature df ApiRican <br />Addrtr;s <br />Z__Z ' t s mod' l Kirt. <br />Telephone' um er � <br />Date <br />Fee �� O �f <br />Dept. Approva <br />Engineers _- <br />Street <br />Communications -- <br />Planning_. <br />Approved by <br />Date Approved <br />