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!Y!f(y� \ <br />� APPLICATION'FOR FSIGHT-OF-WAY USE PERMIT <br />Type or Drint clearly wtlh mk <br />��� PRESS HAqD - YOU ARE MAKING COPIES <br />PUBLIC WUHKS . <br />EVERETT, WqSH�NGTON PERMIT NO. � <br />APPLICANT �UNDEflSIGNED) AND FIRM REPRESENTED, IF AN'f: � �j �% � — . ___ ,]�' <br />HEREBV APPLIES FOR PERMISSION TO ' <br />AT THE FOLLOWING LOCATION _�� ,�,_,�� 1-/'.r�–.d�! <br />DRAWING (WORK TQ BE DONE) OR THREE PLANS ATTACHED: ?�'�G <br />i i�� � � ) <br />., � <br />/' <br />�>'- �. �-.. �/ <br />G'�� .f� <br />��/��� i <br />--� <br />; � i �' , ,C;, ; <br />. . ,; � . � j �,' <br />�, '�J <br />. � ���� . � . <br />PERMIT !S VALIf� FOW 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL F�R INSPECTi�'JN 259-881 1 <br />24 HOURS BEFORE CONS'fRUCTION <br />uvt: <br />DEPARTMENT APPROVALS <br />COMMUWU1�ONn <br />i <br />PL�NN W G <br />srn[[i <br />/ r <br />r � � 0/� <br />APPqOVED FOR CONSTqUf'ilJh- --�) � �%.1F <br />APPROVEGA�GONg�6U:.-iF.D CaiC <br />(. � ,�� <br />�� � � � <br />����/� <br />J <br />DRIVEWAY SECTION <br />� T�I <br />�- f I'� LIP / � <br />� <br />�_ 30'�_ _�!__ 1.30" <br />T�e endersigned ownm hereby agrees to hcld antl t harmless <br />❑re C�P/ ol EvereU Irom any an0 all claims br aama9c=_, rosis. <br />��zpCn5C5. OI Cd�5C5 0I dL�iOl1 �Ildl rtld`/ lfiSC bCCIIL^C OI uLI311dIi0n <br />nni� maiNenance ol Ihe vnprwumGnt or ot�er nghl�o4wxy use <br />nvmlo appLc� lo� nnU IurR+cr agrecs lo remove same upon noM1CC <br />Irorn �M1r Gily :v�C to repldcc pubLc properly O�mOgetl ��ere�y. <br />%t'�-":.. ,'�r/' � f!, i/�. <br />S�GNAiUHE Of A�PIiCANi � 1 Y— <br />i ��� } .. � <br />�'ICY: �� <br />�EL[PM0l1E Nl1A1pER PUEHNAtC <br />' /� �+ _ <br />041F <br />1978 <br />