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�� everetl <br /> "� iqppL!CATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or priM Clearly wiih ink <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> � PUBLICWORKS PERMITNO._�v 3� ��,t <br /> � EVERETT,WASHINGTON / ` / �� � <br /> �c(' � IC N�+ �N - Co�vi-2 r� G �°h-- I <br /> APPLICANT (UNDERSIGNEL)AND F:RM REPRESENTED. IF ANY: � � I � <br /> �I CA vrc + <br /> iHEREBY APPLIES FOR PERMISSIOtJ TO <br /> � � � � C� �b � <br /> AT THE FOLLOWING LOCATION <br /> IDRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: � <br /> L �C-tP� <br /> � /+z 3`l0 ?l„ f � i' <br /> � C�1�LI�- <br /> II Replace broken sidewalk on Colby at southwest corner <br /> of property. <br /> � S/�J� � �.�.�- � 2 .0 � <br /> I N � <br /> �� <br /> �I <br /> � <br /> � � <br /> � <br /> , <br /> , <br /> � <br /> � <br /> � <br /> i <br /> ORIVEWQY sEcriora <br /> IPERMIT IS VALID FOR 60 DAYS � � <br /> ! Cppy OF THIS APPLICATION TO BE POSTEU I" uP <br /> �, ON J08S�TE. �30�� �30" <br /> CALL FOR INSPECTION 259-881 1 <br /> II 24 HOURS BEFORE CONSTRUCTION The untlers�gned owner hereby ngrees �u hold and seve hormle55 <br /> �he Gry ot Evemll Irom any and all tleims lor dama9es. costs. <br /> e�penses.or teuses al action Ihat mtq arise because ol mslallalion <br /> �' and maintenance ol Ihe improveme�t or otner nghl�ot-way use <br /> ' heieto ap0��ed b�n�d�w�ner a9ree5�.•�emove same upc�notwe <br /> liom Ihe City entl Io replate OubliC property CBmeged Ihereby. <br /> DEPARTMENT APPROVALS <br /> SEWER � � . ' � ' C�MMl1NILATIONS / I <br /> � ',J . .. .. . .. - � �X �T/��" " <br /> DRRINRGE - TRAFfIL <br /> �� <br /> I <br /> r V•-' �`� ''" PLANNING SIGNATURE OF APPUCANT I� <br /> WATER �U I �o <br /> ............... ..._....__. . ._ . . <br /> � AODRE55 <br /> STPEET ) Il..-'.��' 'yl� ,. � :•l rr � � ZU � <br /> `�V��� 2iP <br /> C.� e "�,.�r .. ,..: '1 GITv <br /> l �.- ' 1� ;�— �0/3/ So Z s'y- z c �S� z s s - z s �� <br /> �'� ATE <br /> APPROVE�FO CONSTPUCTtON n�tEiaNnr[ <br /> TEIEVHONE NUMBER <br /> � �°l� l � 8 � y 23 - $ ° -- - <br /> oere DME i <br /> qpPROVED ASl:ONSTRUCTED I <br /> CONSTRUCTION/AS BUILT �EE 1978 <br />