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i I <br /> � I <br /> I <br /> % everett <br /> ; Q APPLIGATION FOR RIGHT-OF-WAX USE PERMIT <br /> � Type or Orint clearly with ink <br /> _� PRESS HARD- YOU ARE MAKING COPIES I <br /> IPUBLIC WORKS U� �SZ <br /> EVERETT.WASHINGTON PERMIT NO. <br /> APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: 1��W�'v� GD�M STYj�LTI O� I <br /> i <br /> HEREBY APPLIES FOR PERMISSION TO �—`����— <br /> I <br /> AT THE FOLLOWING LOCATION �S � V ��' �� �v� <br /> � <br /> � DRAWING (WORK TO BE DONE) OR THRE►l PLANS ATTACHED: <br /> �I PAe���IU l�r �. sT7�2w� ��aA� �1 Ab� }�ool��.�,P, <br /> � SeQ. a.��u.�f� SF;��� , I <br /> � <br /> ,I I <br /> I I <br /> I I <br /> � <br /> i , <br /> � _ �I <br /> II I <br /> � � <br /> i <br /> � <br /> I i <br /> � ° � <br /> I ; <br /> � <br /> i <br /> , , <br /> �I DRIVEWAY SECTION I <br /> I <br /> �I PERMIT IS VALID FOR 60 DAYS � --i �, <br /> �' COPY OF THIS APPLICATION TO BE POSTED L I <br /> il � t I'� LIP <br /> , ON JOBSITE. I 30" i �30" <br /> �i CALL FOR INSPECTION 259-881 1 f <br /> � <br /> I 24 HOURS BEFnRE CONSTRUCTION The undereignetl owner hereby agrees fo hold and save hermless � <br /> Ihe Cily ol Everet� Irom eny anE all Uaims lor damages. cosls. I <br /> ezpenses.or causes oi action that may anse because ol installation i <br /> and memtenance ol Ihe �mprovement o� other nghl ol-way use <br /> hereto applie0 tor enC lu:iher agrees to remove same upon notice <br /> Irom Ihe City an0 10 �e0lace pubhc pmperly damagee Inereby. I <br /> DEPARTMENT APPROVALS <br /> I S��yFq COMMUNICATIONS /11�`1 I <br /> OR/INA3E iRRFGIC 1 U I� <br /> � v <br /> W�TEp PLANNINO SiG�NA1URE Of APPLICANI II <br /> �1rq) ��X `�5� � <br /> STREEi — ADD� I <br /> ��� � E�G'uL.ET� W�SH- �I�20� i <br /> S�V �� GiTv 2iP � <br /> l� ZS� " �I �� <br /> AP OVEDFOR STRUC N nnre <br /> , . ��� iE�M��U�E��� I� � I PLTEANATE - <br /> AFPR EO AS CONSTRUCTED t� DniE <br /> CONSTRUCTIOIJ/AS f3UILT ,EE jgjg I <br />