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everen <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with mk <br />PRESS HARD - YOU ARE MAKING CppIES <br />PUBUC WORKS � � � ' <br />EVERETT, WASHINGTON PERMIT NO. �� � <br />APPLICANT (UNDEFSIGNED) AND FIRM REPRESENTED. IF AN1': <br />HEREBY APPLIES FOR PERMISSION TO <br />AT THE � OILOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />���- <br />� }�-pP <br />; <br />� ��P�c-S <br />P <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF i HIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-8E'11 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWEA <br />ORAIN/GE <br />STREFT <br />DEPARTMENT APPRUVALS <br />COMMUNiCniiONS <br />TFAFFlC <br />PLINNiNG <br />.�. �T /�)�i� !� � <br />qpp � F/ C NS UC IOy��i N — /� oATE <br />�PPROVED AS CONSTRUGTEO ��^�� <br />� <br />� <br />/ � � �'U~ <br />DRIVEWAY SECTION <br />i I'� LIP � <br />L <br />30"� _�_ 30" <br />The unCersigned owner hereDy agrees lo hoie antl save harmless <br />t�e City ol Everelt Irom any anJ ail claims lor tlamages. cosis. <br />expenses. or causes ol achon Ihat may nnse because ol installatien <br />antl mBinlenBnLC O� Ihe imprOvemrnl or Ulhpr n9h401-w0y use <br />hPreio apP��etl ior antl IurlhCr agiees to remove same upon nOlicc <br />Irom Ihe City dnd lo replace public p�opeity Ua�nagetl Ihereby. <br />� �_, t-_3b`1 <br />iRE�MONE NUM�ER ALiERN�iE <br />' / ,� � '� - - - ----- <br />�:- _ <br />