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everen <br />� APPLICATION FOR RIGHT-OF-WAY USE <br />Type of print clearly with ink <br />PRESS HARD - YOU ARE MAF ING COPIES <br />PUBLIC WORKS <br />EVEFiETT, WASHINGTON � <br />APPLICANT (UNDERSIGNED) AND FIRM REPRE iENTED, IF ANY' <br />HEPEBV APPLIF.S FJR PERMISSION TO_ <br />hAv <br />PERMIT <br />AT THE FOLLOWING LOCATION �° 7�� ���� � P�� f i�� �� Urt <br />�n,�—�� — <br />DRAWIMG (WORK TO BE DONE) OR THREE PLANS ATTACHED: �1" - <br />PERMIT NO.�� <br />. / �� <br />C_� i h.C. <br />CcIK,�.7/T1D�J/r9G /9P/��iif�G - iYf�'IS�.1� �L�il/S TD � ,��'E�d.F� <br />%�� 3�z z��'C� <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />STREET <br />A R VED FOR CON T�1 C�ION / -onrE <br />� / i <br />�>�� �/�/r /y ,�-� <br />APP OVC AS CONSTPUCiED �/TE <br />CONSTRUCTION/AS BUILT <br />DRIVEWAY SECTION <br />r� I" LIP � <br />r30�� _ 30,� <br />Tha un0ersigna0 ownor hureby agrees lo hold entl sevo �armless <br />tho Ctly ol Everett Imm any unE all cleims �or tlemegas, cosls. <br />oapenses. or causes ol ection ihat mny nr�se Ceceuse ol installnl�on <br />an� ma�Menence ol Ihe imprmomenl or ol�cr nghl-o4way use <br />�erelo apPbed lor entl lurlhe� ag�ees lo remove same upon notice <br />Irom Ihe Gily an0 to replace pubbt property damagetl I�eieDy. <br />/J � <br />'�'�' /f%tA `R/�1� — <br />SIGN U E Of RCP Ni <br />.o, iy <br />nooAcss q.�j �J� / <br />! L"�� /T� (/�/ S� <br />cirv z�r <br />25c/-/DD / <br />1ELEPMONE NUMBER A��<<�NA�� <br />