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<br /> Q AFPLICATION FOR RIGHT-OF-WAY USE PERMIT
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<br /> PRESS HARD - YOU ARE MAKING COPIES
<br /> PUBLIC WORKS �/// 3
<br /> EVERETT,WASHINGTON PERMIT NO.
<br /> IAPPUCANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY: ��1GR-�- �`�i.i C..f� �� r i-y
<br /> '� HEREBY APPUES fOR PERMISSION'.O �-1�/L�Z� ��/�U C7:- F l�L��- ✓ �-�'�i7
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<br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED:
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<br /> ORIVEWAY SECTION
<br /> PERMIT IS VALID FOR 60 DAY5 � _ _�
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<br /> COPY OF 7HIS APPLICATION TO BE POSTED i����p
<br /> � ON JOBSITE.
<br /> ' CAL.L FOR INSPECTION 259-881 1 �..30�__ _ _}�30'�
<br /> i 24 HOURS BEFORE CONSTRUCTION
<br /> I The untlersigneG owner �ereby agrces �o �oltl an0 save harmless
<br /> Ihe Gty of Evere�t Imm any and all Ualms for tlamages, ws�s.
<br /> �I evpMses.or eauses ol acbon ihat may anse because ol installahon
<br /> antf maintenance ol ihe �mprove neni or ot�er ngh�-ol-way us�
<br /> ����iaio dppLetl lur pntl ivrlher qqre5 to mmOve s0me opon nol¢e
<br /> � D„ni Inr [ilc an�l Io �rplacr pubLc p�nPrriv �laniau�'�1 Il�rrt•by
<br /> � DEPARTMENT APPROVALS
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