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, . <br /> � - <br /> everetl _—_ <br /> Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT I <br /> v Type or piiM clearly wdh mk <br /> , PRESS HARD- YOU ARE MAKING COPIES <br /> � PUBLIC WORKS <br /> , EVERETT.WASHINGTON PERMIT NO. � � <br /> i <br /> � APPLICANT (UNDERSIGNED)AND FIRM REPRESEN/TJED, IF ANY: <br /> IHEREBY APPLIES FOH PERMISSION TO—��`-�`�" �y :��-"-^���'� v <br /> AT THE FOLLOWING LOCATION �V�` �—"�-v?V� �y�ll„ <br /> � <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> /, : ! .� /_ - ,' // _ <br /> � ' — ��r , , r/ _� ._ .:li� . . � � � , .a'!.� / <br /> I �d <br /> / % <br /> �== � �� r, �% ���, , ,� ' <br /> , ; , <br /> ;� ��" i-T' :f - , f � � <br /> � �; <br /> ���vC�<�� -- �? '`-`��.�.��. �� � ,��/��y <br /> C��/J�'GS/�I/�i.V' a�i7%7��Gc/` %✓d/'�L :'I� Sl/J��_ <br /> ♦ � <br /> ��r��e��j /U/3 i S'� , <br /> � <br /> I <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAVS � � <br /> COPY OF THIS APPLICATIO�1 TO BE POSTED I" �la <br /> ON JOBSITE. � gp�� I 30" <br /> CALL FOR INSPECTION 259-961 1 <br /> 24 HOURS BEFORE CONSTRUCTION The untlersignea owne� hereby egrees to �old enE save harmless <br /> ihe City ol Evere�I irom eny entl ell clalms lor tlnmeges, casts. <br /> aKpenses.or tause9 0�ection Ihat mey ense b¢cauve uf ms�allnbon <br /> antl m2inlPnance O� th¢ improvPmeni Or Ot�2i ng�l-ol-wAy uSe <br /> herelo BpO����or BnC lur�her agree5lo remove same upon nolmc <br /> �rOm Ihp Ctly Hn0 lo r¢pIBCE pubht plOOQl�� OBTN9pO I�IE�Pb� <br /> DEPARTMENT APPROVALS <br /> SEWER �OMMUNILATIONS I <br /> DRRINRGE TqA(RC <br /> Dl4vi� (�. � cK� K - <br /> WATER PIqNNING SiGNniUAf O�nFGIiLAN' <br /> �7(� 7�1 �I-t ��L <br /> STREET ADDRE55 � <br /> ��,'.- 1 /� �, „ l.�c:���' Ii'2oS <br /> >� , • � / ,i.. �� i_.� �\ ,'.�•` .-, . cirr z�o <br /> APPfiOVED FOR CONSTRUCTION D�rE ��� ry C ( � �5 � _� Z` � <br /> R � <br /> 1ELEPNONE NUMPE� qIiERNAiE � <br /> Y`'�f+I�CI♦ Z� � '�1S U <br /> APPROVED AS CONSTqUCTED DATE DnTE <br /> REFERENCECOPY �eE 1978 <br />