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_ <br /> i ., � , <br /> , <br /> evered APpLICATION FOR RIGFIT-OF-WAY USE PERMIT <br /> � TyPe or print clearly with mk <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS PERMIT NO. dv/ / I <br /> EVERETT,WASHINGTON _ I <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: <br /> � �'A� S I�✓�rG (✓' C- I <br /> � � 0.�2� / I�I✓i CSC� I <br /> HEREBY APPLIES FOR PERMISSION TO � � /� � P U/ <br /> II�`� WR�r (/ <br /> �U� �- I,� U GG v S v� �� <br /> � 2 'Z / S' %u /I`�o n S� - <br /> AT THE FOLLOWING LOCATION <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: � <br /> �OfZ � c%e� ��r- �n � /`•��i� ct'C��c� i�r� 'cl _ <br /> �.i-� �y C/rG., �`— r�`- ,�o� n� .� �fc�l. � dl�r 3G0 � !r.»i��'��'� �/ <br /> �,,[ /�� ri.� /1��, r/,�../� 4�/9 <br /> G�— <br /> . I <br /> � <br /> I <br /> t <br /> �, <br /> �I <br /> I <br /> � <br /> � <br /> I <br /> ORIVEWQY SECTION <br /> PERMIT IS VALID FOR 60 DAYS l�- —� I <br /> I <br /> COPY OF THIS ARPLICATION TO BE POSTED I" LIP <br /> ON JOBSITE. �30�� <br /> � 30" <br /> i <br /> CpLL FOR INSP��.CTION 259-881 1 r <br /> 24 HOURS BEFORE CONSTRUCTION Tnn untlersignetl owner hereUy egrees to hold nnd seve harmless <br /> the City ol Everetl Irom nny enE all elnims ior domn9es, eosts. <br /> ezpenses.or tausos ol aclion I�at may anse Eecduse ol mslallnhon <br /> anA mdiNena�ce ol ihe improvemenl or ot�er nghl-ot�way use <br /> hmeto npp�ied �or antl lurther agrees lo remave same�Oo���nObce <br /> Irom Ihe Cily antl lo rep�Bte puO�iC properly damaQ��l lO�Jeby. <br /> DEPARTMENT APPROVALS � � I <br /> I �(AV�S �^Gr 1V� L <br /> SEWER COMMIiNiCATi0U5 <br /> OROMRGE TRRFFIL _ 1/ .� <br /> �..-� Cjn�'% �— . <br /> WATEF PLANNIN� SIGNATURE O`APPLICAN � <br /> �, ��i � I ��G SSa�U I <br /> � , �,�, ���. �.�;ii � �, "� ;-� <br /> �� �� ' n0un / � <br /> s.ne� ' �:j _ `" T �' y�(� %uciYJ� <br /> c � 2✓C� 1 <br /> /' � . CITv 21V -- I <br /> �- 17U� I <br /> �z- S �ay5 �ss <br /> qPPriOVE OR R C ION ' , °A� � <br /> TEIE�HONE NIIF E� RLiERN��iL <br /> � ��`� � � � �G <br /> I <br /> _ �''� oarE <br /> APPRO D AS ' STNU ED.. .. U��rE <br /> CGNS i RUCTIG�!/AS [3UILT �ec 1978 � <br />