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+ - s 6 <br />fVffC <br />� APPLICATI�N FOR RIGHT-OF-WAY USE PERMiT <br />Type or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVEfiETT, WASHINGTON PERMIT NO.Z�j�7 <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: �/VA� '//�/IJiC'/P �67/ <br />HEREBY APPLIES FOR PERMISSION <br />J <br />AT THE FOLLOWING LOCATION <br />%Z <br />� � � � <br />Q /T � ✓�- h! <br />E UE.��'�Ef=� <br />� <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />�'�j�� C�i2/UC�'�/�_ C.(J �,�����l�Jl1��A,��%:y�Q��'Cf% <br />v � Y�- �=� <br />�-�U <br />-� ���a� —� �.�-- (�y,�- �� �����.G�� c-�-�, <br />�t �-v� — �� ��-et-��,� �� ��Vcc,u� ��-�Z . <br />. �� <br />WERMIT !S VALID POR 60 DAYS <br />COPY OF THIS APPLICATION TO BE PO,STED <br />ON JOBSITE. <br />CALl. FOR INSPECTIOf. ?�9-881 1 <br />24 HOURS BEFORE CONSTRUCTlON <br />DEPARTMENT <br />SEWER <br />OfiA1NNGE <br />� <br />wnntn <br />����_������ � ��' <br />APC OVEDFORWNS UCTION oqTE <br />� i <br />� `�l, ^ � / � 3 - �='� <br />APPRU ED AS CONSTR C ED _ OnrE <br />. , i�. _ -"]I ' _� . . <br />DRIVEWAY SECTION <br />f I" LIP �� <br />�_�3�" r �30"� <br />The undersignetl owner hereby ngrees �o hold antl s,�v� harmless <br />the City of Fverett Irom any and all claims lor dam.ges. costs. <br />ex0ense5, or causes of action ihat may arise because ol nstallnlion <br />antl main�enance ol �he improvement or other nghl-ol-way usc <br />here�o apOhetl for antl lur�her agrees to removc san,e apon notree <br />Irom Ihc COy antl Io repince pub6c property damar;etl t�ereby. <br />nooaess� � � � <br />,�. �1 <br />� <br />z -�--�� y �v <br />__ � 5 �— i> �i �,, �,. <br />iELEP��ONE NUMBER ALiERNFiE <br />�1.oh� <br />DAiE — <br />