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� <br />evereM ' <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print cleady with mk <br />, PRESS HARD - YOU AHE RAAKING f;OPIES <br />PUBLIC WORKS � ' � <br />EVERETT, WASHINGTON PERMIT NO._1�/� <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY: <br />HEREBY APPLIES FOR PERMISSION <br />ATTHEFOLLOWINGLOCATION .'ir�;��� C�i7���`'> <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTIOl�1 259-88'1 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAiNAGE <br />WATER <br />DEPARTMENT APPROVAIS <br />COIUMUNiCrlT10N5 <br />,Anrric <br />Pl4NNiNG <br />CONSTRUCTION/AS BUILT <br />ir <br />DRIVEWAY SECT�ON <br />� --� <br />� +I" LIP <br />� <br />�30" T _�30" <br />The unAersigne0 owner hereby agrees lo holE anA save hermless <br />Ine City ol Everett Irom any nnd all claims br pTmaBes, cosls. <br />evpenses. or causes ol action �hal may anse Decause ol installetmn <br />antl mamlenanre ot Ihe �mprovement or ol�er nqhl-ol-way use <br />hereto appliPO �or and lur�her agrees lo remove Samc upOn noiice <br />Irom Ihe Cily ana to replace pu�lic property tlamaged Ihere�y. <br />�� � ��� <br />SIGNAiU�E Of nvPLIC4Ni <br />592g o,o.�c�s <br />���2=Ti' GBZo 3 <br />�53-o�'j4 J 25S=15i4 <br />*E�ErrioHE Nunno[a q qi��qNqrE <br />� �i3' O� <br />