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everen • <br />� APPLICATlOIV FOR RIGHT—OF—WAY USE PERM�T <br />Type or print cleady wilh ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS � � � � -� <br />EV[RETT. WASHINGTON PERMIT NO. ti� � Z <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED,-dFANY: � ' � � <br />HEREBYAPPLIESFORPERMISSION�'TO t�!'��F'j�l�/� .c.,��f�l � � �L����� /�%t; %�i1����,7r�r`�! <br />r^s�l /`,(���'/ /%C $� /.tl�i%��.�' �.h'J�/Ti= f%�L`f%//a`%i'�G— <br />AT THE FOLLOWING LOCATION O'Y`L /�' <br />DRAWING (W7RK TO BE DONE) OR THREE PLANS ATTACHED: <br />'/f' ,U._�t': i_�,�,�' 7c? ,�.�GG•'1L� �.PCjf�.l�-S �G.� S T.�:�.0 / J'i':: �'�Ar' �" � <br />.� / r .G: �r <br />2`� lci�7� s�f�i ���,t,�5 �� L'1�J�1=�.�%�.:. ;�'.�'.�Fc•rt.�-:�is�i�z/G <br />/=�P,Y!�J�� �I�Jb �faf'aSt�j }=fC►l,CJG/itl,t_= r=f 4,� <br />�'� � i 'l /i/'f'�'n�,i4G � G t� �7''� t:: �"i�'.� <br />,E',�'ic�,Z �'�i C�cn.JS � �t/�C7-f��J. %�� t�'�P�,E' <br />'�'�' i�''�� �,��,�- 5 T��'�sil�z rf� �-G.�:.+�c���l.<� d-�'C sd/ <br />�- i,�--���i�.l: !` ��r � s �,f'a..��. �.��,�.r.�,�� 1��vri�t=� � � � d���=`�` <br />�'�ll-).-`'-� J n�l-(C° �71.'7,�` /�5 .�'�'�tt��'t`:'t"..�:`� % `'"i!-:= �'.,r ,." 1 . . i . 1. <br />j��; �r%�-� �'' r , j; .'`r . �' .✓;'�r",;,�"= �- -- <br />%�'t� <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR IIMSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRI;CTION <br />DEPARTMENT APPROVALS <br />COfdMUNICA NS <br />1qAFFIC <br />., <br />�.� <br />PLANNING <br />COf�STRUCTION/AS CiUILT <br />DRIVEWAY SECTION <br />I�� LIP <br />r30'� _�_30" <br />The untlersi8netl owner hereby egrees to holtl and save harmless <br />�he City o� Everetl �mm any antl all claims lOr tlamA9es, costs. <br />expenses. or causes ol action that may ariso Oecause ol installahon <br />and mamlenance ol I�e improvemenl or o�her righPol�way us� <br />h2rCI0 dOPhCO IOf 2nd lutlhef a[fr¢CS 10 rCmOVC Sdmc upOn noliCf <br />Irom Ihe City and to re0lace pu�lm property dama9ed tnereby. <br />� ' J <br />T 1 J ❑MBER � ALIEPNATE <br />o�,E <br />�� —G Lv � �O ' -- <br />