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De <br />CITY CNGINEERS <br />EVERETT•WASHINGTON <br />The Undersigned <br />Hereby applies fo <br />APPLICATION FOR RIGHT-OF-WAY USF PERMIT <br />PERM ITNO. <br />�_..r <br />At the following location <br />SKETCH <br />(Work to be done) <br />DRIviny sECTIoN <br />NO SCALE <br />I" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON •IOBSITE. <br />CALL ENGINEERING DEPT.259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Wetar Valve <br />Drainsga <br />Curb b Gutter <br />Sidewalk <br />Inspector's Signature <br />Date <br />Remarks — <br />Note: Original to Customer <br />1 Copy to Fite 11008 <br />1 Copy to Inspector <br />The undersigned owner hereby agrees to hnld and <br />rave harmless the City of Eve,gtt from any and all <br />Cia'ms for damages that may arhe because of mstalla• <br />tion and maintenance of the impinvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public, property <br />Clam feroby.//�� A OF/�. <br />Jrg azure o scant <br />�eil t h�fV"umaK� <br />Date n <br />Teo —-I� _.. <br />jy-- <br />�ept. A rmral <br />,� -- <br />Engineers — <br />Water_ <br />Street —- <br />Communications — <br />Traffic <br />Planning __— <br />Approved by — <br />Date Approved <br />