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i , � <br /> everetl <br /> Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> v Type or prinl clearly with mk <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS <br /> EVERETT,WASHINGTON PERMIT NO. � -C <br /> p ' . � <br /> i. . / <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: ���' � �i- � '�- <br /> HEREBY APPLIES FOR PERMISSION TO_ � <br /> AT THE FOLLOWING LOCAT�ON 31OS-/�/A/E S'r EvE.rE7T GVA /B20/ <br /> �� <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> � ICRv� GO fJrovecll �I - ZZ — $ I <br /> f <br /> J� <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS � �! <br /> I <br /> COPY OF THIS APPUCATION TO BE POSTED + i" LIP J� I <br /> ON JOBSITE. <br /> CALL FOR INSPECTION 259-H81 1 i�30 '�i �_30" <br /> 24 HOURS BEFORE CONSTRUCTION <br /> T�o unUersigneE owner here0y agrees lo holG and seve harmless <br /> Ihe Ciry ol Everett Imm any nnC all cieims lor Cemeges, rosts. <br /> expen5es,or causes ol attion t�at mpy nrise becBosa ol inslallalion <br /> anG mamtenance ol the impmvement m othcr ngb�vbway use <br /> ncrcto upp�ie0 Iw nntl Wnne�agrees Io rcmove same upon nobcc <br /> IrOm Ihe Ciiy anG to �Cpldce puGl¢ pmperly tlnmagetl Ihemby, <br /> DEPARTMENT APPROVALS <br /> i <br /> SEWER COMMUNiCFtIONS <br /> OR�INAGE TRAFfIC ''�� .��� , � � <br /> ! i 1/��� n /� <br /> }�(,}i..n—� 1 ' L" F/a..Y <br /> WATEII PLANNING SIGNRTpRE Of NPPLICANT � <br /> � . -;� '/% ,<l, � 1 <br /> SIREET AODAE55 %' i <br /> f'�� �� p d: . _r. �. /����. � .t.e;: ,. . r <br /> ,.. , <br /> '����/ GIiV 21P <br /> A ///O���VED FOR C TqUCTION Dn*E ' .� � ' � <br /> � � /�� LLLEVMONE NOM�ER RLTE�NFIE <br /> 0 <br /> � _ <br /> � APPPOVEUASCONSTRUC OniE�. �<iE <br /> NSTRUCTION/AS BUILT ,E� �g�g � <br />