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� 4z�y <br />everen <br />'� APPLICATION FOR RIGHT�OF-WAY' USE PERMIT <br />Type or print cleerly with ink ry�// 7� <br />PRESS HARD - NOU ARE MAKING COP�ES ' d <br />PUBLIC WORKS ' � , <br />EVERETT, WASHINGTON PERMIT NO.�► <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION <br />�_ <br />V `� <br />AT THE FOLLOWING LOCATION ZD 3� /–/�r /�/,�S% <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />CONDITIG:?S <br />� <br />Thut pottion of driveway within public right of way must be paved. <br />PERMIT !S VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-88 t 1 <br />24 HOURS BEFOI�E CONSTRUCTION <br />sEwEn <br />DEPARTMENT APPf'OVALS <br />COMAIUNICATIONS <br />DRFINAGE TNAiFlC <br />WRTER ^ (�� �ANII�ING <br />� l: <br />—�� �� \ '�r� ` <br />STP[ET � <br />�_��' ,�� A <br />�\� , �/2�/�� <br />APPROVE FO CONST UC�ION �—?9 D iE <br />// �' "� / -�/� <br />APP SCO TPUy; .. � �� �I\\' II�J WLY �/' c. <br />:�'.�-j �r. <br />� . OAiE � <br />'Y � �'+'" � rCONSTFlUCTION/ASBUILT <br />DR�VE'NAY SECTION <br />r— --"� <br />�— � I" LIP �l <br />L.3p�� � 30�� <br />i <br />T�e untlersigned owner here0y a�rees to hol' nntl snue harmless <br />Ihe Ciry ol Everetl Imm any end nll cleims fcr tlemages, cosls. <br />erpenses, or wuses oi action t�al may arise �ecause ol inslallaiion <br />antl mainlenan�e ol Ihe improvement or olher righl�o�-x�ay use <br />hereto appbed lor an0 lurther agrees Io remove sdmc upm) nobce <br />Imm �hC Ci�y dnd lo replacu v�oi�c pmpeny tlamage0 I�ereby. <br />� [/�✓ / � �i��Q-- <br />SIGNRTURE Of APPUCANi - <br />,�o �a /,''�,�/.-ST <br />AOORESS <br />�:�,-�Ti ��G � <br />�,,. Z�v — <br />�Ss- 3/L o <br />TEIEV��ONE rvL1M0ER ALTERNAIC <br />�T/�y/�' / <br />oare � - — <br />7978 <br />