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., evereti <br />e <br />_ . _ ..�. 1:: <br />APPLICA'�101� FOR RIGHT-OF-WAY USE PERMIT <br />Type or priN clearly with ink <br />PRESS HARD - YOU ARE MAICING COPIES <br />PERMIT NO. f�� ��� <br />PUBLIC WORKS <br />EVERETf.WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FI.�M REPFESENTED. IF ANY: <br />HEREBY APPLIES FOR PERMISSION TO—�— <br />� <br />AT THE FOLLOWING LOCATION _ � � <br />Fr ,�?��' <br />DRAWlNG (WOFtK TO BF DONE) OR THREG PLANS ATTACHED: <br />P. <br />CONDITIONS <br />— d maged - any damage done <br />1. <br />2. <br />3. <br />Existing sidewalks, curbs and gutters are un a removed and replaced to <br />to same during construction wili be repaire� or, <br />the P.W• Inspectors satisf�.ction. if new drivewa;�s have <br />Existing drivewaYs should be utilized for new homes, <br />location - KNOCKING OFF OF CUCtB� �T <br />to be instalied - the existing curbs and gutters must be totally rem��e <br />and replaced at new dri��`NaY <br />AL.L_ O_ WED' <br />All concrete removals must be saw-cut or take�: ^.'��� ?o nearest expansion <br />joint. <br />PERMIT �S VALfD FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTiON 2�9-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />ptiAINnGE <br />DEPARTMENT APPROVALS <br />COMMUNiCAT10N5 <br />1nnFF�c <br />_' 1--i i. ' ' '�1 [— . ' <br />' I � �' � <br />WATER '( ��J '�1 ':J �.�� PLANNIIIGi <br />u � ;i <br />STREET <br />�iL�.l <br />/ i � � T � �/Pd <br />1 DATE <br />APPRO�ED F CONSFfiVGF�O:J �. ., <br />_ ,.6�--/_✓ --� <br />__ ,..,.� <br />..� ..�!'LCAv..�.'rv'�IwC-i.. <br />�;> <br />DRIVEWAY SECTION <br />i <br />I" LIP <br />i 30" � 30" <br />i � <br />The undersigned ovrner hereby n9rces to hold nnd save ha�mless <br />Ihe City ol Everel� Irom any antl all claims lor damages, costs. <br />expenses. or causes ol nclion lhat may arise because ol ins�atlation <br />an� maiNenance o1 Ihe improvemenl or niher ngh4ol-w�y use <br />herelo apphed �or and lurther agrees Io remove same upon notme <br />Irom Ibe C�ty ana lo �eplacc publ¢ properly aamagetl Ihcreby. <br />Sf���ST�o � �.v�« i��.s i�c� <br />:;'%���C�/�-� y - <br />/SIGNATURE OF P�PLICANT <br />A,D�SQ�X �/� -�/ <br />/�,«��;�.� c v,� y�--o.�3 <br />11P <br />�,.� <br />� ��—�L/Cr� ALTERNAtE <br />TELEPHONE NURIBE <br />7 � --- --__- . _. <br />