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eve.en <br />� APPLICATION FOR RIGHT-OF-WAY I►SE PERMIT <br />Type or print cle�rly wilh ink <br />PRESS HARD - YOU ARE MAKING CQPIES <br />Pu9uC woaKs PERMIT NO.-S�— <br />EVEF9Eff. WASHINGTON � <br />APPLICANT (UNDERSIGNEDj AND FIflM 9EPHESENTED, IF ANV: � <br />C� 3ROw�•1 C.oN'Sr��c'Ticy.� <br />� �,c-� / 7' fISP�/� T <br />HEREBY APPLIES FOR PERMISSION TO C��S - <br />h�„ir„iAv ���� r�_i_.�ss �� . <br />,-, � r, <br />AT THE FC�LLOWING LOCATION <br />�� <br />4-� -sa <br />DRAWINCa (WORK TO BE DONE) OR THREE PLANS ATTACHED: P' – <br />�' C% �' ` /�J �T. i! ��i! �i /^ L� TC.: ��� 0 � (/ �� �/ Df^ CJ/�.' �J/ � <br />� x CFSS �cLiA�,� ��-,�M �x�s��,t.� <br />�� X i�iV D I Z'� 71 L t To G�s � s�Dr ��.�rd�r�i�y <br />P0� ,����lL <br />3�31�8D <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />C/\LL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />ENT APPFOVALS <br />CONSTRUCTIGN/�S BUILT <br />' � ' �pR�k,�WAY SECTION <br />��, � - <br />I'� LIP <br />� 30" � � �30" <br />The undersignetl owner hereby agrees to holtl end save harmless <br />Iha Ciry of Everett �rom any .^.ntl ell cleims lor damnges, cosis. <br />expenses ur causes oi action Ihat may arise �ec�use ol inStNlation <br />nnd ma�ntenance OI Ih2 impiovemeni or olher nghl-Obwny use <br />�ereto apP��ed br and luriher agrees lo remove same upon nobce <br />hom me C�ty and to replace pubbc pwperry dnmagM Ihe�e�y. <br />r���� - � <br />, iJ. `�,�.� <br />SIGNAtU�E OF APPLICANT <br />��l3�3 55 ;�� A�-- �. E. <br />AOOPE55 <br />M n�f�'� u i �LI:_. w�s t� �1827 C� — <br />CITV ZIP <br />� � � _ � � AItERNAi[ - - <br />TELEPH E N MBER <br />� %�y �o <br />DAT <br />