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� /� <br />evereh <br />� APPLICATION FOR RIGH1'-OF-WAY USE PERMIT <br />Type or pnnl clea�ly w�qh mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUFILIC WORKS , . <br />EV�_RETT, WqSHINGTON <br />PERMIT N <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANV: �`t'i. <br />i <br />/� / i <br />rIEREBY APpLIES FOR PERMISSION TOL�if�lf J��/� � �, f .� _ �. . _ rf � .. . . �c <br />I �C.____.�e <br />� AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THHEE PLANS ATTACHED: <br />X <br />� iiik.[i______� � c. <br />E a � s ri.✓G- <br />�tix a <br />/4," l�J�L�:�:-.'�40 • /' /�:on� 5�..,i <br />.': Tr���t.�ic,. 3✓cK InS�1D <br />7/lr�` v�//%S %/i/✓ (�17uiA% <br />yo �o �,; ,a,�.> <br />PERMIT IS VALID FOR �O D/!YS <br />COPY OF THIS APPLlCATIOW TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DliAINAGL <br />WaTER <br />I <br />DEPARTMENT APPROVAL�' <br />�COMMIINICAlIONS <br />iFAFfIC <br />P�4NNING <br />E,-.r <br />STR[ET �, R �%iJ!1 _ <br />� ( /,,_�/[_(, � �i n <br />� Z��i.^iA / ' i G-.�\ �'� � ) <br />Af PROVED FO ONSTRUCTION � <br />ORIE <br />� � � � �� <br />AP OV �D AS CONSTRUCTPD �. � UC� /� <br />L i Dr.rE <br />co�usTr,��:;T�ic,r��:�,:; �-,.��,_�� <br />DRIVEWAY SECTION <br />T� <br />I \ i�,� UP / I <br />L 30" 30�� <br />r <br />The untlersignetl owner hereby agrees io holtl anE seve hermless <br />Ihe City ol Evcreli Imm any and all ��aims lor Oamagec, cmts. <br />expenses. or �ruses ol action Ihat mpy prise because ol installalion <br />ana mainten:mce ol Ihe imprpvnmenl or other ngnbol-wey use <br />�urelo applied lor ana Iwiner agrees Io remove samc uDon nohcc <br />born �he C�ly en� te �epiace pubhc property damngetl IhereDy, <br />y . <br />����'•�� � � � .' . i ( , ) . _. � <br />�SiGNAtURC Of qPfLiCANI�. . � ` r <br />,. , <br />� i � . 1 .�h •1 -. � � � <br />ODRC55 <br />lEllcNONE NUN[iCR / ` /^\ /� / \��n�� _ <br />� � � /- <br />OA1E _ _ <br />�3 <br />1978 <br />