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11 <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned LARR <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />At the following location z2y RL • _ CS, E, <br />(Work to be done) <br />DRIVEWAY SECTION 0)0 <br />NO SCALE <br />--I <br />30� <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 8, Gutter 00 <br />Sidewalk <br />Insp 's Signa Q /sIr <br />Note: Original to Customer <br />1 Copy to File 1. 0 0 5 0 <br />1 Copy to Inspector <br />10050 <br />PERMIT NO. / -,�/— /4�3 <br />EWSi C. 0fi{3 «1T <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 same upon <br />notice from the City and to replace public property <br />damBry7ad thereby. <br />blonlitUtO oTApplicant <br />' <br />�sG <br />Address <br />ss <br />phone Number <br />Date <br />no <br />ACME <br />ee <br />l pt. Approvals <br />20. <br />Water <br />17- W <br />Approved by <br />Date Approved <br />% I <br />�/ 7 <br />