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, , T'--, • -� i <br /> 'I T .. <br /> � evrietl <br /> � Q APPUCATION FOR RIGHT-OF-WAY USE PERMIT <br /> � Type or print clearly with ink <br /> �� PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS � /�` � <br /> EVERETT,WASHINGTON PERMIT NO.�-_ <br /> APFLICANT (UNDERSIGNED) AND FlFiM REPRESENTEU, IF ANY:-�i"1�t_�;� ,�''f�N 3L�� S ���� � <br /> r <br /> HEREBY APPLIES FOR PERMISSION 70 /� � ' �" ' , �� v '���� ' '��'f`'� <br /> i <br /> I <br /> 302� . � � � ' .t- I <br /> ' AT THE FOLLOWING LOCATION ��' <br /> ` �� y,w-��. I <br /> DRAWING (WORK TO BF DONE) OR THREE PLANS ATTACHEU: <br /> �a�� I <br /> I <br /> � �---_�_--�-�._���--�` ' <br /> I ..�'------^ _ != I ... . <br /> I , <br /> i � <br /> f / <br /> � ____'' .,��� i�� � <br /> i � � � �� � :� � .� .r ✓ � <br /> / J.` �1; . . . � <br /> I �� � <br /> i ^y�''�./ <br /> � � � ' <br /> � ����_�` � /\- <br /> ; ! i "; � .v� : , , : ���� ; t � ,- `� � <br /> i • \ � <br /> � �,�. ,�- :��/ ��, i <br /> i � <br /> I _ - �' � <br /> , , <br /> � � <br /> I <br /> i <br /> I DRIVEWAY SECTION <br /> ' PERMIT IS VALID FOR 60 DAYS � -� .� <br /> COPY OF THIS APPUCATION TO BE POSTED i" LIP I' <br /> I ON JOBSITE. I 30' I I 30' I <br /> � CALL FaR INSPECTION 259-881 1 I" �t' •1'� � <br /> 24 HOURS BEFORE CONSTRUCTION The untlar5lgnoA owner hereby egreos to holtl en0 s0ve�armless <br /> t�o City ol Evorelt Irom eny an0 all tleims lor tlamages. msls, <br /> expenses.or cau5es al ac1i0�Ihat may eris�baCeUse ol mStallAtion <br /> � end mammnance o� �he impmv^ment or oihor nghi-ol-way use <br /> hereto appbetl lor and lurt�cr agrees to remove same upon nohce <br /> Irom Ihe Cily antl Io �eplate publit O�oOerty dumagetl Ihereby. <br /> DEPARTMENT APPROVALS <br /> SEWER COMMUNICATIONS <br /> ON/•iNAGE iRAf FlL ^ �� <br /> �I Ll`/.... �. 1= ,(-'�_. :t,j�p '1 <br /> WATEfi PLANNMG SIGNATUAE OF APPLICANf 1 <br /> � �/� � /� 1(� 1 l� l �' : /'� 4 ' <br /> STREET � �ODAE55 <br /> U;i"n/v'_' / (� [� ` � "L <br /> � ' J'l �—G� � vc � c c, r <br /> CITY , ZIP <br /> A�VEDFOHCO RUCTJ N / �AtE �Z � � ' /� ! /��' <br /> fELEF�� NENU�d F A�TERNRTE <br /> �� /� _. ,�, � <br /> , �7 f. r <br /> ROVED AS CONS RU TED �aTE oniE � <br /> I � <br /> I CONSTRUCTION/AS BUILT rec 1978 <br />