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Ievrrett � <br /> Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT ' <br /> I �/ Type or print clearly with ink � <br /> PRESS HARD- YOU ARE MAKING COP�ES I <br /> �PUBLIC WORKS p I <br /> EVERETT,WASHINGTON PERMIT NO. �� �U 0 <br /> APPLICANT (UNDERSIGNED)AND FIRM qEPRESENTED. IF ANY: <br /> HEREBY APPLIES FOR PERMISSION TO I <br /> I ' i <br /> AT THE FOLLOWING LOCATION I v � � � � � F � � � C'C l'7 <br /> �..�y-xo ,�}}sk kuyAy r <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED:�" <br /> P�, ��-,ti� ���,.,� � ��� s- � - �� <br /> -� �;'� , ; <br /> ��-,�-�- ;��� ,�. `�� �� � ,�-�-�-=_�-�-�--�_ � <br /> 'J •S �I �� <br /> , <br /> � ���� �� _� <br /> � � �,,- � rv e,,,P _ <br /> /�' f�s� a G <br /> �5���� ��n � s��jpr <br /> � <br /> / /`�� l'��,, r' � I <br /> M� � � /G � <br /> �� <br /> l/'� <br /> 1 6 �� <br /> . <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS � � <br /> COPY OF THIS APPLICATION TO BE POSTED i" LIP ' <br /> ON JOBSITE. � 30�� �� _I _30" I <br /> CALL FOR INSPECTION 239-881 1 <br /> 24 HOURS BEFORE CONSTRUCTION <br /> ' The undersigned owner �ereby agrees to holC Bntl aeve hermless <br /> the City ot Lverett irom any end ell cleims lor tlamages, cosis. <br /> enpenses,or causes ol eclion t�at may arise because of inslallation <br /> antl maintenance ol Ihe impmvement or olher rigM-ol-way use <br /> hpretp appb¢0 lor antl further agree5 io remove Same upon noUCe <br /> Irum ihe City antl lo re0�ace puDl¢ property damagetl ihereGy. <br /> DEPARTMENT APPROVALS I <br /> SEWER ppMMUNICATIONS <br /> ORAINAGE TRAFF,C <br /> 4�� oil <br /> WFTER PLANNING IGNATUREO AL LICAN /� <br /> ��S .EY' )�v�� ✓�cY_ <br /> � STREET ADO E55 ' � <br /> `�SEt � t A9A Evei��-f. rr�Ln.3 I <br /> S � CITV 21P <br /> PR VED FOR CON RUC ION Dnr � �Sg' / 06 <br /> J 6 9 �s...n- �s�y I <br /> j"� /'� TELEPHONENUM9Efi qii[qNAiE I <br /> + � y .:�� n/ �- �� � <br /> APP VE �A CO 5 TED '� �� DATE on1E <br /> � � <br /> CONSTRUCTION/ASBUILT ree 1978 ! <br /> . . � ., - <br /> �3iuws,:�.cK,�.._._ _ _..... _. . _..�__ � <br />