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.'l"Y l�', � .. <br /> everM <br /> � APPLICATION FOR RIGHT-Of-WAY USE PERMIT <br /> Type or print cleerly with ink <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBIIC WOFiKS <br /> EVERETT,WASHINGTON PERMIT NO. �� - �`< <— <br /> !� <br /> APPLICANT (UNDERSIGNED� AND FlAM REPqESENTED, IF ANY: L���'�� I�� � '� ' I ,r' 't �'��� <br /> � <br /> HEREBY APPLIES FOR PERMISSION TO ���5 L l_. IC 1�: I I� �: L`f� � V t \.1-�U.U <br /> AT THE FOLLOWING LOCATION � 1 � i I �� l "' '1 • ` �� ' - <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> b��- <br /> (��f� - ����'� <br /> �- ,�� ; ' <br /> I�5 c-- `�r'� l <br /> [� ��` <br /> Qti✓- �, �r. <br /> ���.}f � �o(es °? <br /> , S ° <br /> �D� u��'�,z <br /> r, No � ��m Jn�L <br /> , <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS {� ---�! . <br /> � I <br /> COPY OF 7HIS APPLICATION TO BE POSTED i" LIP <br /> ON JOBSITE. I <br /> CALL FON INSPECTION 259-681 1 1�30'T �,Ir�3o"., <br /> 24 HOURS BEFORE CONSTRUCTION ���� <br /> --�:�__ <br /> The untlersigned owner hereby agrees to holtl antl seva�armless��- <br /> the Cily ol Everett Irom any antl ell claims lor tlamages. costs. <br /> expenses.or causes of action that may arise because ol installatlon <br /> antl mamtengnce ol Ihe impmvemeni or other nghl-oi-way use <br /> hereto aOP��etl lor antl lurther agiees io remove same upon nobce <br /> Irom Ihe City and lo replace public property damagetl ihereby. <br /> DEPARTMENT APPROVALS <br /> I � . -, ;� ' i . <br /> i � ��I i � � - _ '� <br /> SEWER �I j COMIAUNICATIONS <br /> �_ <br /> ,1 �DNAINNGE j�-�-;� , TRAfFIC 1 �; <br /> ! �� <br /> WATEB +•«............... .. . . . .� PLFrlNI(y ...••. $IGNAiURE OF PPIICANI <br /> TT3;l�V3 ;;.i . '� u�1a 1 <br /> STREET • a�U 2���U`� ��� yG A�DFE55 <br /> q ��.!= ., �=cz�� ��. `�g�l,o3 <br /> �i.�� /J�f-- za / <br /> APPROVED F CONSTRU TION onr , ��t� —� 32 7G <br /> � LE nONE NUMBER �, ALTERNATE <br /> H - 1S-- � 1 <br /> APPRO�'ED AS C(iNSTRUCTED onTE OAtE ' <br /> INITIALINSPECTIONR�QUESTED FEE 1g78 <br />