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s <br />•vrrorl <br />�J <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PERMIT <br />11110 <br />Hereby applies for permission to _ e o n s 1 r• u r t n e o n e, 01W z 1' s,v i e(e Orr <br />r <br />Cr 4 r_onC/'t�Y <br />At the following location 3 53 9 s r 1� S. er <br />SKETCH <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO 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 />Inspector's Signature <br />ate` <br />Remarks 11110 <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 />lion and mains ante of the improvement ereto <br />applied fora urt�e agrees toJ� mov upoJ� <br />notice from o I ff ul to lop J((IB p I' /'oper�jy <br />damaged t ej ,� <br />Fee <br />Capt. Approvals <br />Engineers___ <br />Street <br />Communications <br />Approved by <br />cunalmot Date Approved i <br />