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� <br />; <br />, <br />' <br />everen - <br />� APPLICATION FOR RIGHT-OF-'fR"AY USE PERMI <br />Type or print ciearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES � <br />PUBLIC wORKs PERMIT NO. <br />EVERETT, WASH�NGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION <br />3 <br />AT THE FOLLOWING LOCATION <br />DRAWING (�NORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />GALL FOR INSPECTIORI 259-8$ 9' <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />SEWER <br />TRAFFIC <br />pR�INAGE <br />-�� <br />PLANNING <br />• WqTER <br />STREET /� <br />D� / <br />q P VED FOH S UCTION <br />� DATE <br />APPROVED AS CONSTRl/CTED <br />DRIVEWAY SECTION <br />I - , <br />I" LIP <br />30"�— 30" � <br />7he undersigned owner �ereby egreea lo holtl entl save harmless <br />the Cily o1 Everett Irom eny and a�l cleims for dameges, costs. <br />expenses. or causes o� action lhet may arise because of inslellation <br />and mainlenance o� the improvement or Olher righFO�-way use <br />Irom�IhevCly antl m �epeceaPublc�p�oPeoY dama9etl�the�eby <br />'� <br />� /�� <br />-,61GNAiUAE Oi PPLICANT <br />! ��a��� <br />AODRE55 ���� .^�� � +� <br />7 � <br />CvT Z p <br />CiTV <br />� GS ` S i� q�TERNATE <br />TELEPHONE NUMBER <br />FEE � 978 <br />