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1 e ' <br /> � � eV�•cn APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � TYPe or print clearly with Ink I <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS PERMIT NO. $p�2�0 <br /> EVERETT.WASHINGTON <br /> i t t 1�� <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED. IF ANY:___l�� <br /> / <br /> HEREBY APPLIES FOR PERMISSION TO ^ � � <br /> ,� - - ,. �/c iJi` <br /> AT THE FOLLOWING LOCATION <br /> 7-1'7'SO <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> / ir S�P� i <br /> .Z„�/�,��,>�� /b' ' s�„�/�.:�/� GS�, �� <br /> $e��.z� 1 c�-7 f ILY. G�� G/'vr'7 C-X.�S-�`:>,C C�LI,� � ' <br /> J <br /> / / ///'c' !:�' �- / ).,` <br /> LI) Ci S`.�)C. /1" lZ SLY/ f!/ ('G� C � / � / � <br /> (/ <br /> ���9E_r' C��/'u✓ •���Gi» /c�.2S/7�'! <br /> i C7 / � D ..I� 1"� C�:• S7�Ync!l�.��LG� ( /��C�J.,�-�._, <br /> � ��G'.rr!'L Jf. YD E GU� � p � / ' <br /> �/ / `✓C�7.�Lt.� T'�% JGu t-!� Or^Jp��'�� �i�-..� <br /> /'rr,v� rx:s�;,� e�,L'� � / i <br /> , _ � c>c'�o5s <br /> ' /-a .6� /�� ,,`' ,� �ls i c%�...� <br /> a, id �����,,��.�, � s�- � . <br /> , � � qc:o.���l.�_�' �/e r Gi f� .n� �c.,__� <br /> /'�2^e.wJC�j /Y1L<o 1'� L /�Cr/�e.^ (l � � . <br /> � 6v,'f�.;, ��- u.b/,.�, �• �'� r � <br /> 3 �u t �Y'�=v" � � `� ,�-�Jr� �' <br /> lJa.� iriic r- 6��J�`"`f� � / <br /> .. �.���//C�Jc.o� .�Ji� /�DO��G%-(�"� <br /> .,.. .D d�n.>� <br /> �1, 1n�«.t;i„ r`. /'��u � �.- <br /> Qeru,s� o( Srli�/%:� , � O � '� <br /> / U <br /> D � (JO � /�,,,� / <br /> � V CG' e Z— �—� <br /> C�a'� � >Z� <br /> � <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS � -� <br /> COPY OF THIS APPLICATION TO BE POSTED i" LIP <br /> ON JOBSITE. I 30" I T 30" , <br /> CALL FOR INSPECTION 259-�81 1 <br /> 24 HOURS BEFORE CONSTRUCTION 7he undersigned owner here6y agrees to holA and seve hermless <br /> the Cily ol Everett Irom any end all cleims 1or tlameges, cosis, <br /> expenses.or causes of action ihat may arise because ol ins�911ation <br /> antl mamlenance of t�e improveme�t or olher nght-ol-way use <br /> - �ere�o apDheA lor antl Iurlher agrees to�emove same uDon nobce <br /> Irom Ihe Ciiy and to replace publ¢ pwperly tlamagetl t�ereby. <br /> DEPARTMENT APPROVALS <br /> SEWEP CCMMUNICA1iON5 <br /> DRAINRGE TRAFFIL ///� X'/y/J A <br /> V� � ri "'O�Ce <br /> WATER PLANNING SIGNnTl1RE OF nPFt ICnNi <br /> isi � it3 �- S� � � <br /> . .. ADDrI(K �-l-!/ . P �..� y�o � � I <br /> SiPEET -' i � <br /> / �` C � 21P <br /> � 1. 7�//��OI I <br /> "qppq� R CONSTRUCTION , ,�— DATE y�� 3 yy ti — <br /> /•( TELEPMONE NUMBEP AI�EANAIE <br /> .- �. ... y_ 9- �o <br /> .. DATE..�•• OATE <br /> qVPROVED AS::Oh�i�.� IEDt"ral! <br /> '�'i:� 1(i `i i I,J <br /> ���� ''''�'�ON5�flRUCTION/AS BUILT rEE 1978 <br /> � — ^ <br />