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en ' <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print tlearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO. � _ <br />i r <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: �i9ii"/7/Y �� ���� r�J <br />HEREBY APFLIES FAFi ?EFMISSION TO <br />AT <br />.�i9'� �G' � �! :?G � �,/i,t/r <br />��ING LOCATION �'y` ""'n'/tt`--%�" � . <br />J � v , <br />NG (WORK TO BE DONE) OR THREE PLANS ATTACHED� <br />� 'C `" . 'i �' f%F- <br />C�SS rs.� ��rio� c�rd:%��sr�, S�rtt�alks� <br />� � .w,,,..�s — , -t�.,� •s c�J �� <br />S'��et,� pr , � <br />� �.+ . . . c �.,�.t +h�Nk -��.� �..� <br />,,,,� w.�..,-�. . . <br />SZ t�..k � s�et ��k <br />C f� •s .-.1 �.c. �o:�o� �� �+ — <br />�✓ <br />t �' au �.q ��. �L s �,�d �'�� <br />Y <br />� �o�,� ; F Sf�.�,� �1 ��y b�� w,� <br />, <br />c,�Awrv s�a+�el c� �: b� ? b.tl� ow s s� <br />a'. d �`�`~� <br />, �N <br />{�a ✓-e � <br />�s �� �'f�j �w, w� �� � ✓�8 <br />� <br />IS VALID FQR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />COMMUNICAtiONS <br />onniNnce <br />W�TER �'�ANN�NG <br />L ���____- � �-k-�/ - T `i <br />APPIi V- OR CONSiR CTI N D/.TE <br />pPFROVED AS CONSiRUCTEO D�.*F <br />i �- <br />. <br />�1� ��� <br />' f�� �� �.r��i� <br />• �1�� +. `' • <br />The undersigned owner hereby agrees Io hold antl save harmicss <br />Ihe Cny ol Everett Imm any an0 all clmms br tlnmages. cosis. <br />exyenses. or causes of acfion ihal may anse �c� aur^ ol msiallabon <br />,intl mam�Cnance O� �hp �mprovemrnl or olher ngbl-nl-way ��ve <br />nerMo apVLetl lo� antl lutlhcr , grees lo �emo�.e same uPon �iohce <br />Iwm Ihc C�ty and lo C laCc publi< piopercy Damagcrl ti�cic�y <br />` �. <br />,�(M , _ <br />c.A � �� r • ' � <br />w <br />� ��j � a�r� <br />�D <br />�S '� � / <br />. fsvr�/a� % . ..f.nrG6/.e( l� �/ i <br />SIGNAiU��[ O� AFct IC/Nl <br />/ � <br />�� � Z ..! /�s?.F• L !/3A <br /><U��kSS � <br />Z�2` '[j����� � -� <br />CiTv /,� vi� ..Y�!9—�i ��.�� � <br />�:' i 'j':� - `--- <br />*ELE�'noNf Nuh�bU� � A�tE��h�it <br />�/� % <br />.^A l t ��---- <br />��Qi��__1�. <br />. _ _ _ - —'— ___ — �9%$ <br />