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f`.�•!flif <br />� . APPLICATION FOR RIGHT-OF-WAY USE PERMIT , <br />Type or print Cleerly wi�h mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO._ <br />APPLICANT (UNDERSIGIJED) AND FIRM REPRESEIJTED, IF <br />HEREBY APPLIES FOR PERM�SSION TO ��"� <br />.. 1��� ,,... <br />� <br />'1 'n%. •!- .-� / /- �>i� -;l�!ri r.. .�,t.� ."�CJ <br />1 _ <br />hT THE FOLLOWING LOCATION �� � % � 5 �/ ` % '`� ��'4 � 1 ' �. <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: �� y-�-�� 4,i'v " /� <br />r/!G <br />�Yt <br />� �l e�s '� y'-/f P� ;; ��� <br />SEWEfi <br />OHAINFGE <br />1YATER <br />EiqEET <br />�Gl� \ _ r� 'C�C � ��v. ` o�. l l0 w c�6 � <br />\� J v <br />��v�. �9-� � bd�.�,�� � �,v. <br />l�-� ,` 1C� � �eg�he��� <br />����� <br />s�� . <br />� <br />a. � � ����'� � c �.,� lc�w as <br />, <br />��,�, ...-. l Z�� � w�J C�� � <br />o�. SI� , <br />s ce�.11� �,ob- c-�u� 2P� �s <br />� r, � � c�,�,r�s � � <br />�:T G��y (.�i��n��� oc <br />I �� � <br />% <br />/ <br />L/� �-� <br />DEPARTMENT APPROVALS <br />COhIM1IUNILAiiONS <br />TqAFiiC <br />P�ANNING <br />APPROVED FOR CONSiRUCTION DATE <br />; <br />APPROVED AS CONSTFUGTED DATE <br />� '2, <br />� � �I��. <br />��t s c,re� <br />-� <br />�30,� � �30., <br />The untlersignetl owner hereby r,�rces to ho10 ond sava hermless <br />�hc Ci1y ol Evcretl Irom eny end all claims lor tlama9es, wsts. <br />e�penses. or cuuses ol Oetion Ihat m�y:Inse because ol inslallalion <br />antl maintenance ol Ihe �mprovemenl or ather nghl-ol�way use <br />hereto apphetl lor antl lurlher agmes to remove same upon nat¢e <br />Irom Ihe Cily,antl to �eplace publ¢ propeny Oama9etl mcroby. <br />��4����` �� <br />GN�TU �E+�F APPLICANi <br />� / J r� 5 -f- l7 �t � <br />p RESS <br />%riFrF� �`tL�p cJ�3 <br />C�iY <br />.: S � > �/ 7 � <br />TEIEPNONE NUMBER .-� A�fE�NAIF <br />���s-^� / %�' SD - <br />o�rE . <br />