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ever�n <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHINGTON <br />Newland Construction <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY —_ <br />HEREBY APPLIES FOR PERMISSION TO_ install a 15 F driveway <br />7502 Evergreen Way <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR SO DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL. FOR INSPECTION 259-681 1 <br />24 HOURS BEFORE CONSTRUCTION <br />(IIPART-MgNT APPROVALS <br />I L La <br />SEWER IBGI { COMMUNICPiIDNS <br />DRAINAGE ._........ _,....... .rRAffl91 <br />WATERI'f) NNING <br />STREET <br />APPROVED Port CO STRUCTION IF YATL <br />APPROVED AS CONSTRUCTED DATE <br />RErEFIENCE COPY <br />PERMIT NO. / b <br />DRIVEWAY SECTION <br />T <br />I" LIP <br />3011 �30"' <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 vise because of installation <br />At no maintenance of the in.pro%ement of other righLobway use <br />hereto applied for and further agrees to remove Fame upon notice <br />from the City and to replace public property damaged thereby, <br />SIGNATURE OF APPLICANT <br />P.O. Box 958 <br />Everett, Wa. 98206 <br />CITY -- — <br />259-3161 _ <br />TELEPHONE NOIAR1iR ALTERNATE <br />` <br />DATE <br />F <br />I <br />