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Li <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />A1PPL!CAT!0NI FOR RIGHT-OF-WAY USE PEr1(411T <br />10204 <br />PERMIT NO. <br />The Undersigned _ _ /:j�/ L L; S Y—/aLI� //VC /_ <br />Hereby applies for permission to t__QA/S t Ur• Y 4 2s (_netLI <br />At the following location ZIZ — go A, )L . S. F . Lo T G _ __ <br />(Work to be done) <br />C. <br />DRIVEWAY SECTION <br />NO <br />�"--- :25 SCALE----- <br />I" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 2598811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />14 <br />Inspector's Signature <br />71Z <br />>u -j� j / <br />O <br />.ate to -� - ;i�i/i: /y'(�(iJ, r(7, :;G'S k 4'-' , <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10204 <br />1 Copy to Inspectot <br />c,Duc. p/Vi <br />exa riye <br />CdxD y c'urarz <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 />Date <br />?'30 AV S <br />Fee <br />Appri—`� <br />Date Appro4d ' <br />