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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />ccercit <br />® 10054 <br />CITY ENGINEERS <br />EVERETT, WASHIN11GITON 'ERMIT N0. <br />The Undersigned <br />Hereby applies for permission to _ C D l j STQ , Q 2 V) 10 C W A l <br />At the following locationI 1 'QS pL '� L=. _ <br />s <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259 881 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve f% tp tn' <br />Drainage I`-�� <br />Curb &Gutter <br />Sidewalk ^ <br />41nses <br />ctots <br />L r•• <br />Uate— <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10054 <br />1 Copy to Inspector <br />I ST , 511, � G lwe% <br />ND <br />SC.ALC- <br />�y <br />vner hereby agrees to hold end <br />ity of Everett from any and all <br />that may arise because of installs. <br />ice of the improvement hereto <br />Cher agrees to remove same upon <br />y and to replace public property <br />damaged thereby. <br />Slgna>futti of Applicant <br />Address <br />— J <br />Telephone Number r <br />Date <br />7y <br />PI <br />Approvedby <br />Date Approved 9IZ7 j4 <br />7y I <br />