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ev e=o tt <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />The Undersigned <br />Hereby applies for permission to r S : i ,"i 7- <br />At the following location i /�'.✓�.�'.� lii 1� <br />(Work to be done) <br />10914 <br />PERMITNO. <br />DRIVEWAY SECTION <br />The undersigned owner hereby agrees to held and <br />NO SCALE <br />save harmless the City of Everett from any and all <br />—" - <br />claims for damages that may arise because of installa- <br />I" LIP <br />tion and maintenance of the improvement hereto <br />30. <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby.,,� <br />Signature of Applicant <br />//J / ,r/~��s���sie <br />COPY OF THIS APPLICATION TO <br />Address <br />BE POSTED ON JOBSITE. <br />; 1 - 77 O CR <br />CALL ENGINEERING DEPT. 259.8811 <br />Telephone Number <br />G/77 <br />24 HOURS BEFORE CONSTRUCTION <br />Date i , <br />CHECK LIST <br />Fee <br />Water Valve <br />Dept. Approvals <br />Drainage <br />Curb & Gutter <br />Engineers "-� - <br />Sidewalk <br />Water <br />11 <br />Street <br />Communications <br />Inspector's Signature <br />Traffic <br />Planning <br />—Date <br />Remarks <br />Note: Original to Customer <br />^ <br />1 Copy to File f l' nn J i 4 <br />1 Copy to Inspector <br />Approved by <br />Date Approved <br />