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W <br />CITY ENG 'NEERS <br />EVERETT,WASHINGTON <br />APPLICAI ION FOR RIGHI-OF-WAY USE PERMIT <br />11110 <br />PERMIT No. 78 _ 2- <br />The Undersigned D a// n.5 C- / s r i J r <br />Hereby applies for permission to con 3 Y r< n >' n e a n c, or? _ <br />C {v r'roi2f-1-1& <br />At the following location 363 9 / S 7� <br />(Work to be done) <br />DRIVEWAY SCCTION <br />NO SCALE <br />l tl" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />Remarks <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 />damaged thereby. <br />Signature of Applicant <br />Address <br />Telephone Number <br />Date <br />Fee <br />Dept. Approvals <br />Ensineers-_ <br />Water <br />Street — <br />Communications _T_ <br />Traffic_ <br />Planning <br />111.10 <br />Approved by <br />Date Approved <br />IN51'CCTJR'S COPY <br />r`. <br />v <br />