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- <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with inkere <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO. _T9 aT+ <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY. Ti r ti S <br />HEREBY APPLIES FOR PERMISSION TO D—�� — <br />AT THE FOLLOWING LOCATION /6 O J cT II P 47 C C-- <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />2I -A L L 11 0*c C *.; <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FAIR INSPECTION 259-811:I1 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />DEPARTMENT APPROVALS <br />COW"UNICATIONS <br />TRAFFIC <br />WATER 1 �i I PLANNI <br />STREET <br />P ROVED fORN TR CTION O E _ �pgC RW <br />�/01 <br />APPROVED AS CONST CTED DATE <br />Y <br />1 DRIVEWAY SECTION a <br />1 <br />I" LIP <br />1 30'WI - 30"IN <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages. costs. <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other nght-ol-Way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public properly damaged thereby. <br />' <br />SIGNATURE OF APPLICANT <br />I Ltk1L-5-C' 'b1...� <br />CITY LP <br />?JSS`LIa�I <br />IQ , 197 <br />CONSTRLICTION!AS BUILT <br />