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l <br /> ► <br /> � _ - <br /> _, <br /> � <br /> Ieveren <br /> � APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or pnnl clearly wrth mh <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> j PUBLIC WORKS � <br /> 1 EVERETT.WASHIIJGTON PERMIT N0.�1�— <br /> APPUCANT (UNDERSIGNED)AND PIRM REPRESENTED, IF ANY:_'��` -�--T" �� T �1�+ C�t��'I I, I • <br /> HEREBY APPLIES FOR PERMISSION TO �'E»»v� �}��N C• 1� �L'r� li:.IG (,Q'I W.(.1 �.J � .� <br /> �?� � ;� �� z /a C C t �.1 rro W A � �Y�. M c� TL�� — � <br /> IAT THE FOLLOWING LOCATION Ly �� N LW � � _ <br /> I <br /> i <br /> I DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> I <br /> I <br /> � <br /> I Ii I <br /> i <br /> I <br /> il I <br /> � I <br /> I <br /> I <br /> `� I� <br /> �1 <br /> � I <br /> � <br /> � <br /> DRIVEWAY SECTION <br /> i <br /> PERMIT IS VALID FOR 60 DAVS � ----.i I <br /> I COPY OF THIS APPLICATION TO BE POSTED i" uP <br /> ON JOBSITE. �30�1 � 30" � <br /> CALL FOR INSPECTION 259-881 1 '�� <br /> 24 HOURS BEFORE CONSTRUCTION Th� undersigned owner hereby agrees to ho1C a�a se�E na,m�e:s <br /> Inr C�ty ol Evemtl Irom any end all claims�. lor dameges. costs. <br /> 1 I e.penses.or causes o�ec�ian that may anse hecxuse of inslallahon <br /> � i Tnd mmntenance of t�e �mprovement or olne� ngnt�obway use <br /> � nrrMo aVO��etl loi nnd Iw�hci agrees�o remove same upon nohw <br /> Irom I�e Cily antl to replBce pu�hc pmOrrly O:mmBgeO th¢�eby. <br /> DEPARTMENT APPROVALS <br /> SEWER COMMUNICAilONS <br /> pRAINPGE TRAfFlC .- <br /> �� _�.z0� � ,,,. . .yi..� — <br /> � � �yqlcq PIANNING 9G tURF.01 A1'�L Nt <br /> � v���l�G ���'��✓� �i� - <br /> s1nEE' noo�[ss � <br /> � , G,' G'J2L;?'_ ;��S ?� <br /> � � � . , n Crtv _ `jIiP <br /> I AF OVEDF /��/S�RUCTION J /A/ z1 � p�) � � � JO ���` <br /> ������,/�I�' �/ tEL[PaGNE NUMBER RUENN�tE <br /> i � ,• 7-�z— � � / / <br /> � APPROVcD AS CONSTFUCTED DnTe �^�� <br /> CONSTRUCTION/AS BUILT Fee 1978 <br /> ' �y1F. � � . . . . -� . .. ,.. - .. <br /> � \ ... ...,. . <br />