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�vrrs•II APPLICATION FOn nIG11T•OF•WAY USE PEnmIT <br />CITY ENCINFERS <br />EVERETT,WASHINGTON PERMIT NO. <br />ThoUndcrsiuned__t��C•C'Itncs T'Lr�yi�t(r t s aT <br />Hereby applies for permission to C 0, z s i �� i Q i- <br />At the following locations /-e+ T <br />SKETCH <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />�---- fI" LIP <br />1301, 1 <br />j <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259.8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb &Gutter <br />Sidewalk <br />Inspector'iunature <br />`vote <br />Remarks �. <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for dansages that may arise because of installa• <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />not' Irom the City end to replace public property <br />daignat rde therapy <br />"%v�� <br />If <br />c/ J <br />Address — �-- <br />3 ,•--1--2 nor <br />Telephone Number <br />/O(:Z y /JC <br />Date <br />Dept. Approvals <br />Engineers__ <br />Communications <br />Planning <br />Approved by - - - --- <br />CuJMI?lr.n 0810 <br />