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- i <br /> �� ►- I <br /> � I Yrr.�i <br /> � APPLICATION �6R F�iGiiT-�r-�'�AY JS� FEFM!'� <br /> Type or print clearly with mk <br /> PR�SS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS PERMIT NO.��t7� <br /> FVERETT.WASHINGTON � � � <br /> i i <br /> �,/j` � .�����;i 1 � <br /> APPLICANT (UNDERSIGNED) AND FIRM REPRESENTEO, IF AN1':._/�JJ--- '��(���„ I <br /> HERELs'i A�PLIES FOR PERMISSION TO (�� <br /> � I <br /> 1 ( f, �_a n� - <br /> AT THE FOLLO\NING LOCATION_I��-- <br /> DRAWING (WnRK TO BE DGNE) f)R THREE PLANS ATTACHED: <br /> �f�7 �-// . r/ /�,'�� 1 / <br /> T (-�"�--� ��_` �/� � �w" � . <br /> _,t�'�. / <br /> 1 y� ` <br /> / l ' '/ _� �, �y����i . VC�7�( <br /> L/�''�' ;� <br /> � <br /> I <br /> � <br /> � <br /> I <br /> I I <br /> I I <br /> � <br /> I <br /> I <br /> �I DRIVEW.IY SECTION I <br /> I � I <br /> PERMIT IS NALID FOR 60 DAYS � <br /> COPY OF THIS APPLICA710N TO BE POSTED i" LIP <br /> I ON JOBSITE. �30" <br /> i <br /> I 30.� <br /> CALL FOR iNS�ECTION 259-881 9 f <br /> I 24 HOURS BEFORE CONSTRUCTION 7hc un0ersignetl owner hereby agrees to hold and save har�nless <br /> the C��y ol Evere�t Irem any and all claims lor tlamx?es. wsls. <br /> ex0enses.or causes of action ihai may arise because o�installation <br /> and maimenance oi the unprovement or other nyh4obway use I <br /> hereto aDPhed lor and luriher ngrees lo remove same upon not¢e I <br /> Irom �he Ctly ana to re0���e pubLt properly tlamagetl Ihereby. <br /> DEPARTMENT APPROVALS I <br /> �� <br /> SEWEP CONMUNICATIONS / <br /> � 1 / ' <br /> TRAFFIC :' � ���1 ^ � <br /> ORAIN;AE - . ' � Y / _ <br /> � PINNNING SIGNA�APPI.ICANf � � I <br /> I WATER . • �,��1 ' - _' , ;, — <br /> f� ' /']� <br /> � ��'� ��� � A��R 55� 1 � � <br /> STREET ,, � / — � � <br /> / ,�. <br /> I . � / � � � ZIP <br /> � CITV <br /> � ,��� ��" y7 7�-/ <br /> 'qp F VED FOR`CON RU 1 ON � �,`',1n� A�E <br /> i. TEIEPHON NUA ER PLTERNATE <br /> .� � <br /> r ;�,;:' •-' ..� ;}�i�l 7 � - <br /> D��E DNTE <br /> PPROVED AS CONSTfl CTED . <br /> , (�ONS�RUCTION/AS' f3UILT �EE 1978 <br />