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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 />11002 <br />PERMIT NO.�7 %— 29 Z <br />At the following location <br />SKETCH <br />(Work to be done) <br />DRIVEWAY SECTION <br />- NO SCALE <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 Signatu,n <br />—bate -- <br />Remarks <br />Note: Original to Customer /� <br />1 Copy to File 11002 <br />2 <br />t Copy to Inspector <br />ScG /,�7'f�C%jED <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 />damagtld thereby„ <br />Sidnatur9of Applicant <br />Addr s <br />i S d�i umber <br />eT IeplYo �J� <br />Date <br />Fee jC11 <br />V o 'O 0 <br />6ept.; -Approvals <br />Engineers t' <br />Communications <br />Planning <br />Approved by <br />Date Approved <br />