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cverett <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />1.1393 <br />The Undersigned .. - , _.r ,-1 <br />PEHMII NO, <br />Hereby applies for permission to <br />At the following location_7 � _ �� 5?_�__�F_ <br />SKETCH <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />II **nn tI" 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 />ff//i K <br />Inspect s Signature <br />ate <br />-?_9_ <br />Remarks <br />11393 <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 mai tenance of the improvement hereto <br />applied for Oid further/agrees to rdmove same upon <br />notice from She City and to replace public property <br />damaged thereby. , <br />Signature of pplicant <br />i <br />r <br />Address <br />Telephone umber - <br />Datq r <br />Dept. Approvals <br />Approved b <br />Y.�.c.t.i <br />INSPECTOR'S COPY Date Approved a <br />