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� <br /> � — . � � � � i <br /> i <br /> everetl �• I <br /> Q APPLICATlON FOR RIGHT-OF-WAY USE PERMIT <br /> � Type or print clearly with mk <br /> _/ PRESS HARD -YOU ARE MAKING COPIES <br /> PUBIIC WORKS I <br /> EVERETT,WASHINGTON PERMIT N0.�3/3 <br /> �� 1 � <br /> APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: I V a h S V'tiyrG (✓� C.. <br /> HEREBY APPLIES FOR PERMISSION TO � I O V2\ / ILI✓' O�CL' <br /> _ �o'r �" �J O GGv S f�� � �"4-e �`��� W-Q�er lil,�'i,� � ( u/ <br /> �, I �� Ij� y <br /> AT THE FOLLOWING LOCATION ��' ' '—' ` `�� �� 2 Z � S � G ��U/7 S/ i <br /> DRAWING (WORK �'O BE DONE) OR THREE PLANS ATTACHED: <br /> ��0� � c�'e�l� �-c�r- ! � �,y/f ��t'Uac� ��� '�/' <br /> � ' �' +5 — <br /> �i.-L �� C/�l.n t C. f' .�o� n! ,r �r�/!.� dJ-r 3GU � fr,r�i/Jr�%� / <br /> �:v_ /..� r;,�c />�r, s/,r./� `.��/9 <br /> G.;_- <br /> I � <br /> I I <br /> I � <br /> � � <br /> I <br /> I <br /> i <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS � --.�.I <br /> I <br /> COPY OF THIS APPLICP.TION TO BE POSTED (�—� i" LIP <br /> ON JOBSITE. <br /> CALL FOR IINSPECTION 259-881 1 jr30';� _L3o" <br /> 24 HOURS BEFORE CONSTRUCTION Tho unAersigned owner here6y BgteeS ia h0�tl ontl save hnrmless <br /> the City ol Evemtt Irom any antl all claims lor aamagoa. cosls. <br /> expenses,or tauses al aciion Ihat mPy Ofise because ol mslallqbon <br /> and mnintenance ot Ihe improvement or oth^.i nghl-ol�way usc <br /> �ereio applied lor antl lurlher a9mc, b remove samc uPon nobce � <br /> Irom Ihc City and �e repV¢c pubhc ryoperly aamn��1 t��veby. � <br /> DEPARTMI=NT APPROVALS <br /> I I <br /> 1 �(O�V`S Grf� IV� C <br /> 5[WER COMMUNiCHTi0N5 � <br /> II <br /> ❑pAINRGE TRAFiIC r' �,, <br /> �� G'�.J <br /> WATEiI Pl4NNIN, SIGNniUPE Of APPl�G4N�/� I <br /> , nr ;` G�� r�� iG ��y �l � I o 55U�v � <br /> stn6e. i I .; t � � _ i p�- � aoo�n �� <br /> � ' Cve�ef-� `1��� ; <br /> � � — <br /> ,. - �J c Z <br /> a sz _��� �,,. t�P <br /> APPROVED� OR � R C ION , � �A�� S� �� 1� �J S � ��'�> li <br /> iELEVHONENUA C�� � AL1E�iNliL <br /> -.��'.. <br /> ��7 � � / � <br /> AVPRO D AS '.S7i7U � ED.: nnrE Dnr[ I, <br /> . <br /> CONSTRUCTIOWASBUILT ni - --- ig78 ' <br />