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_ evgrcH APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Q 10691 <br />CITY ENGINEERS <br />EVERETT, WASHINGTON PERMIT NO.-7 7 _ <br />The Undersigned _ Qj/, c /7/r0, T <br />Hereby applies for permission to c i, <br />At the follow ing location_-?-Yi 9/ 'VA <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE_— <br />1" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE, <br />CALL ENGINEERING DF.PT.259-BR11 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Wetar Valve <br />Drelnage <br />Curb & utter <br />Sidewalk <br />� IAspec{orsSigneturey ��'� <br />-2- <br />ata 77- <br />Remarks <br />Note: Original to Customer 1 Copy to File 1 O S (� 1 <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 installs <br />tion and maintenance of the Improvement hereto <br />applied for and fu,ther agrees to remove same upon <br />notice from the City and to replace puolic Prooerty <br />//yn �-;r <br />Fed i0 V� 7- <br />Nept. pprovals <br />7 <br />Engineers <br />Water _ I� ,7 <br />1p <br />Street_+�7;�_' <br />Communications <br />Planning_ <br />, <br />Approved by <br />Date Approved <br />