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� 1 <br /> I — • <br /> ` <br /> !Ylft� <br /> I APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> I � ' TY�e ar print clearly with mk <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS � � /__� <br /> EVERETT.WASHINGTON PERMIT NO. 79 v <br /> APPLICANT (UNDERSIGNED)AND PIRM REPRESENTED, IF ANY: '� '-' N� ' �� r T/��N d <br /> �Lr <br /> HEREBY APPLIES fOR PEFMISSION TO <br /> Gorvs r�e 2 S t=r ,, � ", ", • S � GU� <br /> AT THE FOLLOWING LOCATION �9�� � �� �/Fn u�GO� ��JC <br /> DRAWING (WORK TO 8E DONE) OR THREE PLANS ATTACHED: <br /> CoN s re �c� T �5 ' Coiuci�c rc ����/clv/1 Y sr"c i�G� �E/E,' <br /> C 1 T % S Tf�.!/!�fJ.eA �/ /ti T�C�Qf�L S/G�€Gd/9L K F"a/e f�T�'P� <br /> PiPvP�,e ;y ��ea�ul�c` o� �,cE,v cc�D. <br /> � <br /> ��� <br /> � � � � <br /> � � lL , l � <br /> �v � � � <br /> P� �� <br /> �� j� S � �� �r <br /> � I � S / <br /> ,�G � u�� <br /> d � � � <br /> �0 c �a D <br /> 1l <br /> �� J � �� �� <br /> � 6�� , � � � �, �i <br /> � , L <br /> Z <br /> DRIVEWAY SEC i ION <br /> PERMIT IS VALID FOR 60 DAYS � � <br /> COPY OF THIS APPLICATION TO BE POSTED � i" LIP <br /> ON JOBSITE. l_30" I �3o"_I <br /> CALL FOR INSPECTION 2s8-88 t � r "r' ' � <br /> 24 HOURS BEFORE CONSTRUCTION The untlerslgnetl awner hereby agree9 lo hold entl seve hermless <br /> tlie City of Everetl Irom eny and ell cielms lor tlemeges, costs. <br /> ozpP.nses,or Wuses of action inel moy arise because ol instelletion <br /> ana me�nlmBntc ol t�e improvemenl or olher nGh4ol�way b5C <br /> nereto apf hea lor antl Iurl�cr Bgree• to iemove 5ame upon nobce <br /> Irum �hC Giy antl IO �eplBt¢ r�oi�c p�Ope�ly dAmd9Etl th0�:0y. <br /> DEPARTMENT APPROVALS <br /> ��� <br /> SEWER COMM <br /> . � ` '/��,�, �V����!/�� �/ , �\ <br /> ORAIN�G TR�F��G'� <br /> WATER PLANNIN � .�'G�ATUREOFAPP�ILANi, / <br /> ���� �� Ci l-[i1 (�C�a�� <br /> STREET eY I�D�E/!/��(/U� Wh �V �J�O_ <br /> �]_C1I�� �� �C.� ! / _ CITv/"•-"7 IIP <br /> APPR]VtD FOR CONSTRU N oA.�- a 9 n� <br /> � — I <br /> � LELEPMONE N MBER ALiERNAIE <br /> I — ' CJ`� L�/7�{ — _ <br /> �r.P��iaivec .',scc>is�nui'.r[ti -- --r."i ..:,,i <br />