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� <br />-� u��9osr' <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or pnnt clearly with mk <br />PRESS HARD - YOU ARE MAK�NG COPIES <br />PUBLIC WORKS <br />EVEfiETT, WASHINGTON <br />,-s�. / . �:�o �%' <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: _ <br />HEREBY APPLIES FOR PERMISSION TO `-�%�L -�� LU �i� ��-U� iL�- `-L� <br />—l-v��L � � �9 r'� � ��f,,���n c�� �/r� � <br />AT THE FOLLOWINC, ! OCATION / X I� i �.( ( <br />/ <br />DRAWING (WORK TO BE DONE) OR THREE PLA S ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 2'59-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPAR"� MENT APPIiOVALS <br />SEWEN <br />DRAINRGE �� � <br />WATER ' 1 ..� <br />STREET <br />COA1hNNICATIONS <br />TRAFFlC <br />P�ANNING <br />�a� � � `l a P <br />APPqOVED F R CONSTRUCTION nr[ <br />APPROVED AS CONSTRU ` ��AT[ � <br />�'� <br />CONSTRUGTION/AS BUILT <br />PERMIT NO. Y� .3� <br />DRIVEWAY SECTION <br />i" �iP <br />I' 30'� �30�� <br />The un0ersignetl owner hereby agrees to hc10 nnd save harmless <br />Ihe City oi Everett Imm any and all claims lor Oamages, custs. <br />eapenses. or cau5e5 0l attion Ihat mny nnse because ol installalion <br />ane mmnlenan[e ol Ihe impiovement or otber nqhLol-way use <br />hereto apVhed lor an0 Iminer agrces Io re2ove same upon no1¢e <br />Irom I..e Ciiy and Io �eplace pubhc prC,2rly damagetl Ihe�e�y, <br />t <br />�"lS� -���/� <br />TELEPMONE NUM�E� �LiEqNAiE <br />-��N/�?/ <br />DATE —� <br />1976 <br />I <br />