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_ � <br /> � everetl APpLICaTION FOR RIGHT-OF-WAY USF PERMIT <br /> � TYP=or print clea:ly with mk <br /> PRESS HARD- YOU AHE fdAKING COPIES <br /> PUBLlC WORKS PERMIT NO. � �3 <br /> EVEnETT,1YASHINGTON , ^� / �_ <br /> APPLICAN�. (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY. <br /> N�,rtj L • <br /> �/..�� t � .—S/ ��vT�i�i-y�/SES} ' <br /> /���`fff�III � .i � �r_ �i�� /�On.E� <br /> HEREBY APPLIES fOR PERMISSION TO ( n�'�� �C� � T <br /> ..� - LDn.f /7i7a N�76vN-�� ' Tb2 �J/�f�� �Ft''T� <br /> �%�:loSS �i�0i✓7 G� � <br /> AT HE FOLIOW G�OC TION .��U� ��G� �2d� !7h/� <br /> ORAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> / <br /> �� � � <br /> i �K � l�2�i <br /> _ _ , . i� <br /> a /�i/ <br /> • �rx� <br /> c1 k cl <br /> � fj,,'�-G,E S� � G� EWs��� .S�� /����- , <br /> I <br /> DRIVEWAY SECTION <br /> P�RMIT IS VALID FOR 60 D'AYS l�-- --+1 <br /> I <br /> COPY OF THIS APPLICATION TO BE POSTED i" �iP <br /> ON JOBSITE. � ..r30"..� <br /> � 30' — <br /> CALL FOR INSPECTION 259-881 1 r <br /> 24 HOURS BEFORE CONSTRUCTION 7he undenigne0 owner�ereby agrea�to ho�d�n0 sevo harmloss <br /> Ihe C�ty ol Everetl from eny end all cisimf lor Camegey costs. <br /> 8%Dln52l.DI tlUSE!OI lC�iO'1�h31 m!y!/Ib b!ClUN OI i�S�Llle�iOf1 <br /> end me��tenance ol the �m0�ovement or olher ngM-ol-way use <br /> hBrelo appbeC fOr en0 Wr��er aBree3 lo remOv!feme uOUn nDhce <br /> Imm ine Cny enE to rep�ace publ¢ property Eemnge0 IhereDy. <br /> DEPARTMENT APPROVALS <br /> SEWEA C MVNiG�TIONS • <br /> DRAINAGE TRAFFtL — 119�Q�--t' ��4- <br /> W�TER i'LqNNING � 1U�E Of�pP�L�LAH�� <br /> >2�7 ��/�FFf </x'2 <br /> 1 �ooness <br /> � 9TFEET <br /> ��� `� .Lf�'.L�� /-/6 -c�� �'v�i��-�' �'�r�c/ <br /> G�Tv Ziv <br /> APPfl YEO FON C N5�1CT�ON (� OI1TE 25 8 /5�. � � <br /> L,�/ TElEPHO E NUMBER �L1EAN�TE <br /> �v � K _ ` � � J•1 �� OAT[ �/��/ <br /> APP�a � k AS GONS A D D�TE <br /> CONSTRUC i ION/AS BUILT ree 1g7g � <br /> . ' y I <br /> � <br /> 1 <br />