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���«n <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT ! <br />� <br />Type or print clearly with mk � <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS � � <br />�VERETT.WASHINGTON PERMITNO.�� Z3-5 <br />APPLICANT (UNDERSIGNED) AIJD FIRM REPRESENTED, IF ANV: i/L�� C� PcLk.YS'.:�L��— 'I <br />HtFiEBY APPLIES FOR PERM�SSION <br />Ci <br />� I �L� � ���C,i�7�L�1�%/! ✓/%L <br />AT THE FOLLOWING LOCATION __(�.-7/"�'�___J'T_ , <br />DRAWING (WORK TO BE DONE) OR THREE PLA�IS ATTACFIED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-861 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMcNT APPROVALS <br />SEWER COMMUNtC�iiONS <br />DRAINAGE TRAFfiC <br />\YATER _ - �: f' ; ' �.PLANNINC�_ <br />. . . . �. - _I .. , <br />-- T ,. �c� � i� / , <br />/-7-3'z <br />- .: a �L'%��'i — <br />�n o - nn;� <br />j� L^ COi�SIrUCrION1i\S RUIL�. <br />DRIVEWAY SECTION <br />� � <br />� j I" LIP <br />�30„ _ �30„ <br />7he undersigned owner hereby egrees to holtl and sHve harmicss <br />Ihe Ci�y ol Everett Irom any antl all clnims lor Camflges. costs. <br />CRj1Cf15C5. O! CdO5C5 O� 2<I10f1 thdl If1:ly dllSfl �]CCfluSE OI iO5lBlldb00 <br />an0 main�enance of Ihe improvement or other ngM-o��way use <br />nereto apt�lietl for ane iunher ng�ees to rnmove same upon nobce <br />hOm Ihe G�ly anif to ieplace 1��i0Lc p�oP��1Y deinegetl Ihe�ebg <br />/�� �s..� , <br />S�GNn�UR[ OF AnP�iC4N1 � � <br />ri �/ 2 � G:—e,sj/ �� - <br />nnnnEss y /� <br />�'�� '2Q�Zc � <br />Y — - � ao — <br />�-f3- y<�7 / <br />TEIEPHONE�.UM6EF ALiE�NAIE <br />��/—�� <br />oarE <br />1978 <br />rl <br />