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APPLICATION FOR RIGHT -OF WAY USE PERMIT <br />rvercll <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />10639 <br />PERMIT NO. "6 - .'_ -/ <br />The Undersigned <br />Hereby applies for permission to C'.. n e t e, Y 2 t fi. eye Jj,,ji <br />At the following location_ *)y 11 =' ?/ is ^ E 4 <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />A V <br />I t 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 />The undersigned owner hereby agrees to nola and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installs <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove some upon <br />notice from the City and to replace public property <br />damaged thereby. <br />Sigr� Il cent V-8 7.� <br />do <br />Address <br />-Z( / , <br />Telephone Number <br />Date <br />Fee <br />Dept. Approvals <br />4 Engineers�r <br />Water ZZ <br />` <br />Communications 4 st:rl 4 u-e <br />Traffic__ <br />Planning . 0* <br />Remarks <br />Note: Original to Customer <br />1Copy toFile 10639 -, <br />1 Copy to Inspector APProved`b I t <br />Date Approved <br />