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• � � � A � Ali-' w /� � � .--. � � ,. � w a:w /i � 'i;,3v <br />E 24u1 �' unncu nue��ex. i u,-,s . n„ <br />everett �Cf�����' v� <br />� APPLICAT'IUN FOR'�RIGH�'-OF-WAY USE <br />Typr, or print clearty with mk <br />FRESS HARD - YOU ARE MAIQNG COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOF PERMISSION <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHFD: <br />�, <br />PERMIT <br />PERMIT NO. /� �a � _ <br />aK l�c�se `�`�"� <br />It is understood and agreed that this is a temporary Riaht-of-taay Use Permit, <br />valid for a period not to excee 90 days irom the date of issuance of <br />Occupancy Permit for 9910 Ever reen S9ay. <br />It is further understood <br />permanent Evergreen Way <br />and accepted as complete <br />the City of Everett, the <br />shall be installed prev : <br />Said remov.31 and/or i t <br />and the undersigned gre� <br />overhead expenses ' curr� <br />ncy agreed that at the end of the 90-day pariod, if <br />��ovements have not been installed by the undersigned <br />y the Public Works Director, that, at the option of <br />emporary improvements shall be removed or barricades <br />ing further vehicle access � 9910 Evergreen Way. <br />lation of barricades sha11 k;e done by City crews <br />to reimburse th� City for t7ie actual costs and <br />by s,tch w�rk. <br />By: � <br />O�aner, i•7estern Sizzli.r' Steal: ilouse <br />5��= S Tip T.�iLJG'�I �t�3Cjl.�� <br />���- <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSiTE. <br />�ALL. FOR INSi�ECTBON 259-��� � E <br />24 HOURS BEFCRE CONSTRUCTION <br />sEvrEi� <br />�n vriAGE <br />1YATER <br />sraEEr �fC�IYPc. i0hot �o.;•+c� lraSc +�v <br />DEPARTMENT APPROVALS <br />APPROVEDFOfl CONSTRUCTION OATE <br />APPROVED AS CONSTFUCTED oAiE <br />„_'r�T�'�: �-�� <br />DRIVEWAY SECTION <br />I'� LIP <br />30" T �L30'� <br />r- <br />The untlersi9ne� owner hereby agrees to ho10 and sava harmles^. <br />Ihe City ol Everett Irom any and all claims lor tlamages, costs. <br />erpenses. or causes ol aclion Ihat may arise bewuse ol ins�allation <br />antl maintenance of �he improvemeni or piher nqhl-ol-way u5e <br />hereio app0ea lor an0 �urlhcr agrees Io remove same upon notme <br />Irom ihe City and lo replace pu�l¢ pmperiy 0. magea tliereby <br />/ \ � <br />SIGNATURE OF APPLiCANT <br />TELEPHONE NUMOER ALiERN�IiE <br />1978 <br />