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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />W <br />q0J61 <br />CITY ENGINEERS <br />EVERETT, WASHINGTON PERMIT NO. 7 t^ - <br />The Undersigned - D n) 16 S d 1 S o rn ?-..1 r <br />Hereby applies for permission to I. fi s t,„ e t o 21 ' G on e D/is/ or, <br />e,:f,. R -O-V/, <br />At the following location _ .309 4 / ;-T A /�" <br />(Work to be done) <br />-- P/L <br />W4f&r <br />=X FLACE 5 C <br />-A-4P4 r /lohc� <br />DRIVEWAY SECTION <br />NO SCALE <br />I 1_ I" LIP <br />I'30'�. - - b0" <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259.8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb &Gutter <br />Sidewalk <br />Inspector's Signature <br />9 —/k --i27 <br />Dati, <br />Ali; <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10561 <br />1 Copy to Inspector <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 sarrM upon <br />notice from'the My and to sfsdI ace 1u Ic �roperty <br />damaged theJebtf , / <br />4✓ 1 . <br />Signature of Applicant <br />Address I <br />Telephone Number , <br />Date <br />Fee /C <br />opt. App a <br />Engl <br />Wate <br />Communications_ <br />Traffic®./ A.o—_ 813017b <br />Planning <br />Appro J by V <br />Date Approved <br />