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♦+t .;r <br />APPLICATION FOR RIGHT-OF-WAY USE <br />Type or print dearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVEFiETT, WqSHINGTON <br />HERMIT ` <br />��'� �i �� <br />PERMIT NO. <br />�— I <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: �� �Nr I�CIr //<' <br />HEREBYAPpUES FOR PERMISSION TO US% A�nl F�� S T�NC- D� / v �9 /Yr yv GiI.'P/�ri� �.C(/.� <br />. _ _ �� <br />AT THE FOLLOWING LOCATION <br />ST <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 7 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SE\YER <br />DRAINNGE <br />i WATER <br />I�tocc♦ � . <br />�`�/'��f/].' � <br />, APPROVED F R CONSTR CTI <br />! -- i �_-;� <br />GOMMUNILATIONS <br />TRAFiIC <br />PI�NNING <br />�' �.3'r'x� <br />�- OATE <br />;� <br />� —7 ^J/ lJ� <br />'a <br />. � <br />ORIVEWAY SECTION <br />� --� <br />I" LIP <br />�-30"_�- � 30" <br />The undersignetl owner hore6y egrees to �old entl savo hermless <br />tne City oi Everelt Imm ony ond all clelms lor tlamages. costs. <br />erpenses, or tauses ol eclion Ihel mny anse because oI installntion <br />antl mamienan[e ol Ihe �mprovemenl or other ngh4obWay use <br />hereto apphetl lor antl Iurlher agrees to remove same upon nohcc <br />Irom Ue Ciiy enA �p repleCe pu0b� properiy tlamagetl Ihcreby, <br />-/�C'� ��P�/\ <br />$IGNATUAE�f PPPLICANL <br />�%% S/�`� %i� <br />n6oaess <br />v r 9S12d3 <br />CITY ZIP <br />�S� 9� 7 �f <br />ELEV ON✓%"(/C/` .. ALiCRNATE <br />' i ��v <br />oarc _ <br />CONSTRUCTIO�i!AS f3UILT �,, --- <br />- - -_ <br />1978 <br />