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PUBLIC WORKS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PERMIT NO.�L <br />APPLICANT !UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: `" /J�/i �'"� �' N tE <br />HEREBY APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION 6 / 0 <br />DRAWING (VMORK TO BE DONE) OR THREE PLANS ATTACHED: <br />10 <br />PERMIT IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />WATER <br />STREET <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />PLANNING <br />DATE <br />I a( 8I <br />CONSTRUCTION/AS BUILT <br />DRIVEWAY SECTION <br />f I" LIP "g <br />�+3� -- �•30" <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, <br />expenses. ortPuses of action that may arise because of installation . <br />and maintenance of the Improvement or other right -of -Way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged thereby. <br />1 <br />