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lVpfli� <br />� APPLlCATION FOR RIGHT—OF—WAY USE PERMIT <br />Type or print cleany with ink L/ <br />PRESS HARD - YOU ARE MAKING COPIES ,�/'/Ey� l <br />PUBLIC WORKS <br />EVERETT, WASHINGTOM � PERMIT NO. � � � <br />APPUCANT (UNDERSIGNED) AND FIRM FiEPFESENTED, IP ANY: -' � '� � �' � ' '—� =' � '-� �J <br />n <br />HEREBY APPLIES FOR PERMISSION TO C� � `� ` � � —''—� � �� i;� � ': � <br />�1� _A _ !v__���T �R������kY <br />AT THE FOLLOWING LOCATION c'��� �'� ~ ���� �� �� ' t� <<� � � �� � <br />�-- '��' (l,� _ 4- � -�� <br />DRAWING (WORK TO BE DONE) OR THREE LANS ATTACHED: ��'/`" — � <br />_� <br />— _ �n 1�U � <br />� � �� I-� l C�� ��`J <br />�J'a�i � � i <br />� � M���� �l�(C �vT/ ��C ST� I c.%io� <br />�����5 <br />�fJ L� <br />� CUG�7 Jv/e�.� i o,e ���T s��,�.e.p•-�a�v �,�a�.�m si��� <br />PI�G�" �S� fi�� S/J� l�YfiG.�f' <br />� �� <br />� e�� <br />� = �'� ��' �;,f <br />, % �==;f'�J� �-c� ,' ��jr"! � <br />� <br />, . �'/ � <br />PERMIT !S VALID FOR 60 DAYS <br />P��e <br />(�l' `r ��/ <br />e�e � �e� `' <br />� � �"' <br />��o� � <br />� <br />, �a�-��� �. �,��� pr/s <br />5 ,� / <br />, / � S � G �' SiS '� (i <br />' e5/�n�a5 <br />� ��d 5 <br />� �a°�� <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALI_ FOR INSPECTION 259-88 9 1 <br />24 HOURS BEFORE COMSTRUCTION <br />DEPARTMENT APPROVALS <br />� � � �,,��'�a <br />�`J°�o�p�� <br />DRIVFWAY SECTION <br />� � <br />�� +I'� LIP � <br />� <br />i'30'� i 3011�1 <br />The undersigne� owner Oereby a9rees to hol[Tand save hermless <br />Ihe Cily of Everett Irom any and all claims lor tlamages, cosls, <br />enpensLs. or tau5e5 oi 2clion Ihni may arisu bC[ause ol inslallalion <br />antl mainlenance ol Ne improvement or olher nyhl-ol-way use <br />hereto applietl lor antl Iwlhe� agrees lo remove Sapie upon nohCe <br />irOm ihe City and lo replace pubh[ property dama9e.0 Ihereby. <br />fi . � _ ..____- <br />� <br />,_ _ :� � r : �, � .� I /'rl '�'�' _ <br />�� ' S�GN4iU5E OF APp�ICANT 1 <br />� 1 I � � l 1 <br />(�` �., <br />l" � /..1.�� � i Y,-•�. — ' <br />nODaE55 <br />(i'.'il,l l % .. \ ' J�� , i . . . •. _ _ . ! ' <br />�... . ... ,. �., . ;. .� i. .. . ' . . <br />..7_. . �,.� ....� � , <br />i �-��ELEPnOYENUhIGEA A�TE�Nl.iE <br />CONSTRUCTIONiAS C3UIL.l" <br />1978 <br />