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� <br />everetl <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type o� print cleerly with ink <br />PRESS�HARD - YOU ARE MAKING COPIES <br />PUBIIC WORKS <br />EVERETT, WASHINGTON / PERMIT NO. ���307 <br />APPUCANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY:�E�___L��=!'��� �'—�—��� /�— <br />HEREBY APPLIES FOR PERMISSION <br />AT TME FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLlCATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTIOrI 259-881 7 <br />24 HOURS REFORE CONSTRUCTION <br />SEWCR <br />DRRINAGE <br />WIITEN <br />STPEET <br />DEPARTMENT APPROVALS <br />GOMMUNiCA1�ON5 <br />}RqFFIC <br />P��NNING <br />APPROVEOFOR CONSTRUCTION DnTE <br />nvvr�CiVL�' :.�.-� �.•:��r=ur�f ,� <br />j" <br />DRIVEWAY SECTION <br />I" LIP <br />30' � • I _�_"f <br />i <br />i�e untlersignerl owner hereby egrees lo ho10 an0 save �armless <br />I�c City 01 Evaret� Irom any antl all tlaims lor damages. cosls, <br />eapenzes, or causes ol action ihat may AnSe Eecause ol mstellalion <br />antl maintenance o� Ihe improvement or ol�cr ngM�ol-way usc <br />�em10 apP��eO lor dna Iu�ihei agrees to remove samc upon not¢e <br />Irom Ihe Cily antl to repiace nuei�c [��opreiy Oamaged Inereby <br />' � l!�GNAP <br />��/ r� <br />�l <br />AO��ES <br />� <br />Oiv <br />�� <br />iEiE�} <br />L <br />�.:�E <br />x <br />.33 <br />Al <br />r� <br />