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s. <br />cvercN <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PERMIT NO. <br />The Undersigned <br />Hereby applies for permission to At the following location__ --- - — <br />(Work to be done( <br />DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br />NO SCALEsave harmless the City of Everett from any and all <br />�---- - claims for damages that may arise because of Installa. <br />I" LIP tion and maintenance of the improvement hereto <br />p _ _ _30.1 1 applied for and further agrees to remove same upon <br />1� -- notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant <br />COPY OF THIS APPLICATION TO Address <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259 8811 Telephone Number <br />2 HHOURS BEFORE CONSTRUCTION Date --- <br />CHECK LIST Fee — <br />Watar Valve <br />Oreinage Dept. Approvals <br />Curb &Gutter Engineers <br />Sidewalk <br />w..e. <br />Inspector's Signature Communications <br />Traffic <br />Planning <br />Date — <br />Remarks <br />Approved by <br />I ILL �prlDate Approved <br />