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APPLICATION FOR RIGHT-OF-WAY USE PE RN11T <br />.'CYrYtt 10017 <br />CITY ENGINEERS ' O <br />EVERETT, WASHINGTON PERMIT N0. <br />The Undersigned G R O N I.t t�l S fV L. <br />Hereby applies for permission to c—c IL !STD r A, = 1 w I rs 2_7-n Al G. B a 1 a wj <br />At the following location " f V "L -- <br />(Work to be done) <br />LOT 1-5- <br />DRIVEWAY SECTION <br />NO SCALE <br />--- ,L, LIP <br />433j <br />C FIv OG Oil', AI'I'I I(.iG If11J It) <br />HE POSTED ON I1iW,I I I <br />�CAIt FN(iINF( ltlr'A� 1)1 I .'S'1 f{FII <br />' I I C()hl'! I lii It'. I II )1V <br />[CHECKLIST I I <br />Water Valve <br />Drainage <br />Curb &Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer 1 Copy to File 10017 <br />1 Copy to Inspector <br />No <br />5CALE <br />ua <br />CV <br />r <br />rn <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 maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />dame ereby. <br />SI n re p icanl <br />t Ad IV <br />Approved by <br />Date Appr _ <br />