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<br /> � APPLICATION FOR RIGHT-OF-WAY USE PERMIT
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<br /> PRESS HARD - YOU ARE MAKING COPIES
<br /> PUBLIC WORKS
<br /> �EVERETT,WASHINGTON PERMIT NC1. 7�f�_
<br /> APPLICANT(UNDERSIGNED)A�ID FIRM REPRESENTED, IF ANY: O G i`fv�a G � /�ti/S .y �/C�. ,
<br /> HEREBY APPLIES FOR PERMISSION TO��N s���� ` ��ti��e�'��j � P��j/J' Ati�
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<br /> AT THE FOLLOWING LOCATION �� �S �E�;�r- y.r'� ��t/ ��� y ��`'����=
<br /> DRAH/ING (WORK TO BE DONE) OR THREE PLANS ATTACHED:
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<br /> �.�„� ��y o ,�- P,�-��, ,y : �.�;�y v��w•�� j
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<br /> yi.ecesscu �
<br /> DRIVEWAY7SEC1'ION g_ �-�'UU
<br /> PERMIT !S l�'A�iD FOR 50 DAYS � �
<br /> CGPY OF THIS APPLICATION TO BE PC�STED � f �" �IP
<br /> ON JOBSITE.
<br /> CALL FE)R 9MSPECTION 259-t387 1 I 30",Ir �30"
<br /> 24 HOURS BEFORE CONSTRUCTION Tne untlersiqned owner hereby agrees lo holtl antl save harmless
<br /> Ihe Cily ol Evere�t Ilom any and nll claims tor Oamages. cosls.
<br /> expenses.or cause5 0l aCtion Ihel may arise beCAuse oi in5tallabon
<br /> an0 mamtenance ol Ihe impravement or other nghFobway use
<br /> heielo ipphetl lor and lurlher egrees lo removc same upon nohce
<br /> Irom Ihe Ctly an� lo �eplace pubhc properlY tla���agetl �nereby,
<br /> DEPARTMENT APPROVALS
<br /> SE1'!Cq COMI.IUNICAI�ONS
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<br /> piiAINFGE iRAFn '�� - �/ /�
<br /> Wql[R PL�NNING � SIGNALIIqE 0�APPLiCFNT
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<br /> SiREET ��DRE55
<br /> � yp �o _ � �•v�y� e (ti�1S�S/ ��'•� 92
<br /> �/ . O n.� zia
<br /> APP OVEO FOR CONS CTION OAr(E' � � �yG� � � �V� ��(�_ �6 7 (J
<br /> ' v tELEPHONENOMBER ALiEqNAiE
<br /> �_it �1/� f�_ / �_ � 5
<br /> i VED AS CONS RUCTF.D OATE D.vE -
<br /> i.ON�.I RU�TIJfJiA�' BUILT ree —
<br /> 1978
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