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�, <br /> � _ r _ <br /> .. :,� <br /> .n�en <br /> � APPLICNTION FOR RIGHT—OF-WAY� USE PERMIT <br /> Type or print clea:���with ink <br /> , <br /> PRESS HARD—YOU ARE MAKING COPIES <br /> PUBLIC WORKS D � <br /> EVERETT,WASNINGTON PERMIT NO.� <br /> APPLICANT(UNDERSIGNED)AND FIRM REPRESENTED, IF ANV: <br /> � <br /> H�REBY APPLIES FOR PERMISSION TO � <br /> I <br /> � <br /> I AT THE FOLLOWING LOCATION G��6 /� — � �f'� I� I�" � � <br /> 3-zb-so <br /> DRAWING (WORK TO BE DONE) OR � PLANS ATTACHED: �v <br /> I <br /> C � � � J � (�,"�,"^- c-,� ��� �•Z. <br /> � �'n.�-�,r..[�r� c ';���-�-� .,G-c:-�-� <br /> � � . ,� � <br /> � ��.� ��.ctit-,.��- � ��� C�/�c-��-u.�--�. ��,.-. <br /> �.y� ,�-vt.� <br /> i I <br /> I <br /> I . • <br /> I I <br /> I <br /> I j <br /> DRtVEWAY SECTION � <br /> PERMIT IS bClLID FOR 60 DAYS {� � i <br /> I <br /> COPY OF THIS APPLICATION TO BE POSTED i" �IP ' <br /> ON JOBSITE. <br /> � � 3��� � I 3���_ � <br /> I CALL FOfR tNSPEC�ION 259-881 t r •r• •t• � � <br /> 24 HOURS BEFQRE CONSTRUCTION T�e untlersignetl owner horeby agrees to ho10 en0 save�armlesa li <br /> Ihe C�ty ol Everetl irom eny ana xtl claims lor Cemeg�s. costs. <br /> eaDenses.or causes ol aclion inal may erise because ol msfallobon <br /> � antl m2intenan[e ol Ihe impmvement o� ot�er nghbol-wey usr <br /> tlerel0 apPlietl lor Bntl Iur�hCr Lgrees Io remove S�mC upon nolite I <br /> IDEPARTMENT APPROVALS Irom me Cny ana m repiace ouoirc Oroperty tl.lmegctl I�c�eby. <br /> i <br /> I SEWER COA161UNiLAT10N5 <br /> 1 <br /> � � �� �i <br /> �RAINAGE TRIIFFIC � <br /> i � <br /> � WATEP PLANNWG SiGNATURE a PL� FNT <br /> i <br /> _ O. :OK 61 '7 � <br /> i <br /> STREET /DDRE55 Q I <br /> ` � �`',,c�-�' / ,�� ' i <br /> lc��,� ��,:� .�—�� —�U � ` �' — <br /> a�. ` / nv <br /> ; � PPROVED F ON TRUCTION DaTE C S � ' 7 � p / I <br /> � LELE�nONE NUMBER RUFRNAlE <br /> '_.�- 9-� � /� .//�d � <br /> � OVEO AS CONS4RUC �niE DaTE <br /> I <br /> ' (1pNgTRUCllOilrilSl'UIIT ,c� --- --- — --��7�y <br />