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everen <br />" Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />♦' Typo or print clearly wi�h ink <br />PRESS HAfiD - YOU ARE MAKING COPIES <br />PUBLIC WORCS � �/ / <br />E\'ERFTT, WASHINGTON PERMIT NO. �� <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY:���NliCls �• MI UG f"�l`-1t.Y <br />HEREBY APPLIES FOR PERMISSIUN TO_ yT�L /ZE 1� �i�/ST / N4 �2.i ��Z.� A� <br />—_�f— <br />AT THE FOLLOWING LOCATION �`J����� � L� (J 1� r <br />DRAWING (WORK TO BE DONE) OR i'HREE PLANS ATTACHED: <br />� UJ'� (/� '� (� l",'�V ��'UCX�C�i ��� ���`V <br />PERMIi IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />'l4 HOURS BEFORE CONSTRUCTION <br />SEWER <br />ORTINPGE <br />STREEt <br />DEPARTMENT APPROVALS <br />COMMUNICATiONS <br />iRAffIC <br />VL�NNiNG <br />� �'�/ � l./�� � , � /�M/ / / — ��/� <br />AVPROVED FOR CO TR `TION � GiE <br />� �—v� %�j_ <br />�Fo�sc�Nz, rr r��--- -.-- — <br />�` <br />' DRIVEWAY SECTION <br />� � <br />+I'� LIP � <br />� 30" j _I_ 30" <br />i T <br />Tho unCemigneE ownor hewby agrees to �old nntl save �ermless <br />Ine Jily ol Everetl irom any ane ell cleims lor dameqes, cosif. <br />e.penses. or causes nl aelion Ihal may pnse because ol mslallatiun <br />antl mainlennnce ol I�e improvomeni or olher nghbo�-way use <br />hereio apphed lor nna I�niher agien; lo removc Same upon n0�¢e <br />Irom tne City nntl b repincc yubb,; prope�tY Oamaged Ihcrr�y. <br />��-� �����' ��, <br />tilGllAtURE Ol APVLICANI <br />BO10 �EVEI�L`( LVD <br />/ Of�NE55 <br />EVERETT I.�1N. 98to3 <br />btr lio <br />3538781 _ <br />1ELCP��ONE NUMOER MIERNAiE <br />4-_l9-80 <br />