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' � everetl <br />e <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />At the following location li l �.14 L� j .�:, . <br />(Work to be done <br />DRIVEWAY SECTION <br />NO SCALE <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBS[TE. <br />CALL ENGINEERING DEPT. 2598811 <br />24 HOURS BEFORE CONS TRUCTION I <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb !i Getter <br />Sidewalk <br />— g C <br />Inspector's Signature <br />aD to <br />Rema�4r�2 ------ <br />Note: Original to Customer <br />I Copy to File n g 7 4 <br />I Copy to Inspector <br />10674 <br />PERMIT N0. <br />The undersigned ownur hcreby 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 />dam re <br />- <br />ignature o pp cant <br />Address <br />Telephone Number <br />Date <br />-- <br />Dept. Approvals <br />Engineers . — ' / 'e <br />Waterl— 1 , -,. {Jic ..r .ram lji" <br />Communications _ <br />Traffic <br />Plamiing <br />F-j Ts. ,Uw, s <br />Approved by <br />Date Approved <br />