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Cva e❑ <br />i,suL <br />CITY ENGINEFRS <br />EVERETT, WASHINGTON <br />The Undersigned (L91. L <br />Hereby applies for permission to <br />At the following <br />tiKETCH <br />(Work to be done) <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />5` e r37-T11(1'fT o <br />0� <br />1) <br />DRIVEWAY SECTION <br />NO SCALE <br />f r' LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 2598811 <br />24 HOURS BEFORE CONSTRUCTION <br />Inspector's Signature <br />ate - <br />- <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10971 <br />1 Copy to Inspector <br />10971 <br />PERMIT N0. 7I 50 -v <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for dam es that may arise because of insta <br />tion and main -ante of the Improv ent her <br />applied fome <br />fur agrees to re �� <br />notice froC)' and to reply p li r grl <br />damaged ty! / / `/6 J <br />1`7yAd41F-10 wr J <br />Telephone NuTber <br />Date <br />Dept. ApprovWs <br />Eng(neers /%i% <br />Water <br />Street <br />Communications <br />Traffic <br />Planning <br />Approved by <br />Date Approved <br />