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cv�fen APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � TYPe or Print clearly wlih mk <br /> PR[SS HARO ��YOU ARE MAKING COPIES /` <br /> PUBLIC WORKS ( , <br /> PERMIT NO._ � <br /> EVERETT,WASHINGTON � <br /> APPUCANT (UNDERSIGNED) AND FIRM REPRESENTED, IP ANY:� M L�'�Pl� n !.� S_7�-• <br /> HEREBY APPLIES FOR PERMISSION TO���M GLI S 1� Cnr�s�Q � ���N��ni �7 NEC.tI � A�' A <E <br /> � ` lc,v� . <br /> F -Arn�1_: � � E�ti,ir� G <br /> AT THE FOLLOWING LOCATION `'�� �_ 1�_�-' ����'�� � l I�I F �� �'L� ' <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: i <br /> � �d�A.r7 0.�C� �T�n b�2�..vS ' <br /> o '�- • <br /> � .. <br /> �-rc157'iti� �rwe.�..a� �.-� <br /> 21w �S �a.. e✓ _ -- <br /> �-�-- <br /> ' �o C�(r o � S,�ewGlks exis �— <br /> 1 �. �-l�l � T G1 r t a.. <br /> � � - 1 � - � <br /> ---�1'� .���Q.�'�— <br /> ✓ <br /> DRIVEWAY SECTION <br /> F'ERMIT IS VALID FOR 60 DAYS I�-- -� <br /> I � <br /> COF�Y OF THIS APPLICATION TO BE POSTED i" �IP <br /> ON JOBSITE. L3o'� � _L3o" <br /> CALL FOR INSPECTION 259-881 1 r <br /> 24 HOURS SEFORE CONSTRUCTION The untlersignetl owner hereby egrces lo hold entl save harmless <br /> the City ol Evere�t Irom any entl all clalms lor aemages. cosls. <br /> Capensei,or Wuses ol AciiOn Ihai ma)'anse becau5e ol installebon <br /> and mninienante ot �he �mpmvement or otner righl-of-way usc <br /> hercto appi�e0 �or a�d�unher agrces to remove same upon notrte <br /> Irom t�e Cily anE lo re0lace pubhe pro0etly Cnmagetl Ihe�eby. <br /> DEPARTMENT APPROVALS <br /> SEYIER _ .GOA/AIUNIC/•TIONS r�` �� <br /> �,:, ., .,� ,,;, . , � - .. . <br /> � ��� '� �;� :} �. ,. 1 � ' <br /> pRAiNAGE u /� <br /> C.1 �.. TRAF`� <br /> � I C � -�'' .CA. <br /> �YRtER -♦��� PLANNWG SIGNATU O�APf+ iCAN� � <br /> oeet s �. . �v�; io - Z�32�J�i��c S, G. <br /> ..... •.••� AOCRESS I <br /> SiREET ....•......... r <br /> �z ,,�-..._1T_..�3V3 �0 YTI� (�1oNRo� `1�3z72- <br /> � ' ;i1du9 ur� $1P I <br /> ������LL�}-- - wt� �a/� ��y- Gzs�1 <br /> qPPROVEDF CONSTRUCTION OA�E <br /> � TELEPMONE NUM9EA RLIEPNITE <br /> I $ - 7- �2� I <br /> qPPROVED AS CONSTRl1CTEU OpTE' �A�E <br /> IRJITIAL INSPECTION REQUESTED �EE 19�8 <br />