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' �� <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print ck�dy wllh mk <br />PRESS HARD - VOU ARE MAKING COPIES <br />PU�9l.IC WOFKS � ' ' . <br />EVERETT, WASHINGTON PERMI i NO.'�/�zs � <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY:i�,Ai� L��Y��L) �� _ <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION _�71[7 �/�, y�����_ / l�, _ � <br />DRAWINO (WORK TO SE DONE) nR THREE PLANS ATTACHED: <br />�� <br />y�3r�� <br />PERMIT Is VALID FOR 60 DAY8 <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INfPECT10N 269-9B � 1 <br />24 HOURS BEFORE CONSTRUCTtON <br />DR�INPGE <br />WATER <br />DEPARTMENT APPROVALS <br />COMMUNiCATIONS <br />TR�iFlC <br />/�r l ' <br />PUN <br />�i i <br />INITIAL INSPECTION R6QUESTED <br />DRIVEWAY SECTION <br />� � <br />I" LIP <br />�30'� � ���30'�J <br />� <br />T�e unCeroiqneE owner �ereCy egreea to �olU enE aeve �ermleaa <br />Ih¢ City ol Everett Imm eny enC all cleime for Oemepee. costs. <br />¢xp2p5¢S. O! CBU525 01 dCIi00 �IIPI T!y Gl132 �lCauS¢ OI inS�Blle�100 <br />anE mainlenance d t�e improvement or ot�er ng�bol�wey use <br />hereto 2pObed lor anG lurl�er agrpe5 lo �emove SAmO vpon nOlite <br />Imm t�e C�1Y ana to �e0�ace pu01¢ property Eemeged inere�y. <br />/' / n <br />�11�.-�il-� �b C �l � .__ <br />SIGNRTURE O� AFPLICRNi � <br />6 v > .� /-�s�_�=�� .l.C, . <br />nooaess <br />� �.��� Lc�t� C�' LO <br />IP <br />3'S3- 5��/7 / <br />TE.EPNONE NUMpER � /•UERNAtE <br />