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ki-- <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned <br />Hereby applies fo <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10203 <br />PERMIT NO. <br />At the following location O — S, e. LO 7— 4 <br />(Work to be done) <br />T IN( CJiiL <br />c' f rr > iZ <br />Nu X I L% <br />DRIVEWAY SECTION The undersigned owner hereby agrees to hold and � <br />NO SCALE _..I save harmless the City of Everett from any and all <br />2S ---- _ claims fo, darnages that may arise because of Installa• ! <br />I" LIP tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />0'________,30"� /-/ notice from the City and to re lace public property ! <br />�y�,f/ �y dam g rPthereby. ! <br />_ S re of lizt, <br />CO OF THIS APPLICATION TO - ? Address <br />FIE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259 88I1 <br />Telephone Number <br />24 HOURS BEFORE CONSTRUCTION Date <br />7S i <br />CHECY. LIST Fee I <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1 Copy to File <br />t Copy to Inspector <br />10203 <br />Appr p ;b�yi/�� r <br />DaWe ApprroJhd <br />