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ii <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLIGAT ION FOR RIGHT-OF-WAY USE PEHMI I <br />• <br />PERMIT NO. ? _L 7 c 1 <br />The Unde,signed 0L ...ten.- .TA' <br />Hereby applies for permistfonto ('OAtST'iZ"eT A :.S�L'o../�^��!� Dlyy <br />At the following location T V r t-IL < e,:r <br />SKETCH O) r <br />(Work to be done) <br />d-UV ll` / <br />SG E Y�TTAG M c 0� Y� <br />0 tray-s <br />DRIVEWAY SECTION The undersigned owner hereby agrees tc hold and <br />NO SCALE save harmless the City of Everett from my and all <br />f.--- -- - - - -� claims for damages that may arise because of installa- <br />tion and mjfntenence of the Img4rovemen eref <br />3c applied f and fur er agree�remov s e L—Q:{.__ __---.__�._ _..I notice I th and to r cep I' ro <br />COP" OF THIS APPLICATION TO <br />A'ddr���J�/G � <br />I' � , <br />OSTED ON JOBSITE. <br />Telephone Number <br />L ENGINEERING DEPT. 2598811 <br />9n� 'g <br />OURS BEFOREC014STRUCTION <br />Date /� <br />CHECK LIST <br />Fee j <br />Water Valve <br />Drainage <br />Dept. App Vals <br />Curb &Gutter <br />Engineers <br />Sldewelk <br />Water__ <br />Communications_ <br />Inspector's Signature <br />Traffic <br />Planning <br />Date --- <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10896 <br />1 Copy to Inspector <br />Approved by <br />Date Approved <br />