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-�:�; <br /> .rren <br /> � APPLICATION FOR RIGHT-4�-WA1F� USE PERMIT �`, <br /> Type or print clearly with Ink � � <br /> , PAESS HARD - YOU ARE MAKING COFIES <br /> � PUBUC WORKS a <br /> IEVERETT,WASHINGTON PERMIT NO.� <br /> APPLICANT(UNDERSIGNED)AND FIRM RLP.9ESENTED, IF ANY: <br /> HEREBY APPLIES FOR PERMISSION TO <br /> AT THE FOLLOWING LOCATION___._ G�D� /* ' � rt"F I� I f' � � <br /> �� 3-Z1�-st� <br /> DRAWING (WORK TO BE DONE) OR � PLANS ATTACHED: � <br /> � A I <br /> �" /;,' �� n � � ; � �.,.,��f-,,_..�. ��,. <br /> ' /}'1.,�,���c�u�v►,. cl.�:�,�,c�,��,.p ��-�: <br /> � � ���c�,� �.r�. ��� ����"��u`ti'- <br /> C� � <br /> i <br /> � <br /> � <br /> � <br /> ORIVEWAY SECTION I <br /> PERMIT IS VALID FOR 60 DAVS � �! i <br /> I <br /> ICOPY OF THIS APPLICATION TO BE POSTED + i" LIP ,� <br /> ON JOBSITE. I <br /> ' CALL FOR INSPECTION 259-881 1 r3o'�� � .3� I <br /> 24 HOUHS BEFORE CONSTR:ICTION The undersignetl owner �ereby agrees to�olU anE aavo hermless <br /> Ihe Ci�y O� Everotl Irom any nnd all claims I�r tlemages. costs. <br /> eapen5e5.or Cau5e5 0l action Ihai may erise Ocwuse ol inslollation <br /> I 3nd mainlEnante ol Ihc improvement or oiher nghboLway use <br /> hcreta appiie0 br BnE lunhei agrees to�emove seme u0on no1¢e <br /> Iwm Ihe Cily anG to replace public propeny tlamagetl Ihereby. <br /> DEPARTMENT APPROVALS <br /> SEWER COMMUNiCATiDNS /� <br /> � <br /> IORAINAGE TRAFFIC � ' �/ � <br /> IWATER PLRNNING SIGNAT E A Li ANT • . I <br /> � . O. �O x Z6 1 '7 I <br /> I STPEET AUDRE55 <br /> ��-� g,�'�� � � <br /> I �i.�i. � d'��:t,, 3- � (- -�U ��r. � s 2 - s � E � Z�P - <br /> I PPROVED F ON TRUCTION OATE — <br /> IiELEPHONE NUMBER p� AL�E�NATE <br /> � � i�- 9_� ��� ��/o _ , <br /> I� OVED AS CONS•TRUC o^TE �^iF '', <br /> I I <br /> COPISTRUCTION/AS BUILT �ie 1978 <br />