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ki <br />APPLICATION FOR RIGHT-OF-WAY <br />Type or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHINGTON <br />USE PERMIT <br />PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: - if 1 tt(/ 111 ) IL . r1I to r"rI`ll_ 1 <br />HEREBY APPLIES FOR PERMISSION TO u, L) 1 �`k _� u2 gj` ` ^ e ,?r <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BY DONE) OR THREE PLANS ATTACHED: <br />d'i'aLth- cl_�olL <br />Existing alley is not to be altered by widening or changing vertical grades. <br />Allowable work is limited to minor grading, clearing hack overgrowth, and <br />adding 5/8" minus crushed rock to improve driving surface. <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-88 t t <br />24 HOURS BEFORE CONSTRUCTION <br />DRAINAGE <br />WATER <br />STREET <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />PLANNING <br />APPROVED CONSTRUCTION ATE <br />APPROVED AS CONSTRUCTED DATE <br />CUSTOMER <br />DRIVEWAY SECTION <br />yl" LIP <br />1 30" 30" 1 <br />The undersigned owner hereby agrees to hold and save harmless <br />The City of Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise because of Installation <br />and maintenance of the improvement or other righl-of-way use <br />hereto applied for and further agrees to remove same upon nohce <br />from the City and to replace public property damaged thereby <br />1 1 <br />iSIGNATURE OF APPLICANT I <br />ADDRESS <br />{; r�z <br />urr !J l ZIP <br />AI <br />TELEPHONE NUMBER ALTERNATE <br />`/ 11-CT U <br />DATE <br />FEE 1978 <br />