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everetl <br />� APPUCA�{ON FOR R1GHT-OF-W,AY USE PERMi� <br />Typc or U���� clearly with irk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PIBLIC WORKS ��7 <br />EVERETT, WASHINGTON P�RMIT N�O. <br />-i. � <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: V'� � ��'� S��''� � 7i �"v <br />HEFiEBY APPLIES FOR PERMISSION TO <br />i <br />AT THE FOLLOWING LOCATION � 5 S� �'� �''�'���i° " '� L� V F'� � T� I <br />DRAWING (WORK TO BE DONE) OR TMREE PLANS ATTACHED: <br />� P.�ie C/ T� STt�i�JA/�i�'bs FD.� S/L��lt1f1L� C�sr ,f'l,lC i�O/✓ <br />/ I � <br />� °.� <br />3,1 o a Y.• <br />_. _ . _.". -_ _ — J <br />id�j s.•T:.,d • )nA�C� �- <br />�irYlF�4fw�IFII� � ..�5,�_—__. � <br />� <br />��. fjr�LwCt �+ -ryL � <br />_.�_".__"_ _"_.. _ . .. _."_^. _ _..__�—'__. L.__-.-..�� <br />�.— � ° � —�I � <br />1 <br />sx� Sll �„/ ��� <br />` �� <br />PERMIT IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION �O BE POSTEQ� <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-691 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />� J �,%1J // zG� <br />APPROVEU FOF CON51 G110N ��� <br />APPNJVED AS CONSTFUCTED OAiE <br />E�T <br />��+,r , <br />< <br />DRIVEWAY SECTION <br />� I'� lIP � <br />�°� _�"3� <br />Tne undarsigneC owner hereby egrees to �010 ena seve hermless <br />Ihe City al Everetl Irom any antl ell cleims lor dameges, coets. <br />PSpP�5C5. Of C9115C8 0I BLIiOO ih81 rtl0y eli52 6EC0USC OI IfI51811e�ipp <br />Bne ma�NenBnce ol Ihe improvemenl or o5her righl-obwey u5¢ <br />�eielo applied �o� ana Iurlher agrces b remove same upon ncuce <br />Irom Ihe City entl to replece publ¢ propnrty tlemnge0 t�e�eby. <br />i <br />7 <br />�,_ .� <br />SiG UA OL APPL�CRNT <br />i <br />/ -i l0 �i i{ �� /✓(+ <br />ADORESS <br />� /f'4' � T ' ti..: r i ,1//v ���_ <br />CrtY 21P <br />3J�/- 3 SrS� <br />iELEGnONE NUMBEA ALTENNRtE <br />- / V - <br />REFERENCECOPY �EE �g7g <br />