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ki <br />CITY EL'GINEERS <br />EVERETT, WASHINGTON <br />The Undersigned <br />Hereby applies f tr permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />At the following location 714 90 14, R S. F. /- o 7' L <br />SKETCH <br />(Work to be donrl <br />DRIVEWAY SECTION <br />NO SCALE <br />I \ ( I" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259BPI 1 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Date <br />-�--- - <br />i- 41T <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10201 <br />1 Copy to In ipector <br />PERMIT <br />,V <br />/✓i: tV C ONC . 0/Q) <br />30. <br />- IV, <br />6XIS r wa <br />C09D ry C dYrLk <br />4 f f <br />10201 <br />7.5 - 8z <br />Iva :7 CHL f. <br />The undersigned owner hereby agrees to hold and <br />save harmless the C;r•, of Everett from any and all <br />claims for damages the 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 />d j thereby. <br />NOa e of I cant !! <br />Address <br />Telephone Number <br />Date <br />74-0 -�tz� <br />Fee f ��7 <br />- I <br />Approv by (, <br />Date A��-�// <br />rs <br />