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ereretl <br /> Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � Typs or print clearly wrth mk <br /> _� PRESS HARD -YOU ARE MAKING COPIES <br /> .PUeuCwoRKs PERMIT NO. p����d � <br /> EVENETT,YlASHINGTON � <br /> APPLICANT(UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: � - — <br /> HEREBY APPL�ES FOR PERMISSION TO <br /> / <br /> AT THE FOLLOWING LOC�TION � - - ' <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> � <br /> , �� � 'i <br /> ,J <br /> l__� �� . � � r. <br /> � � � <br /> 1 i <br /> t <br /> ��� -ci �:'l�1 v�c; ��-�— .._ �.1 . . � <br /> ������ � r.� >> -� � '' � ; <br /> x�� I�� ���� r� " ` �(� r P,,.A C'� :/ <br /> � , C „ 4,1 u. �`� � '� <br /> �\_� ) `, r r�r ' , <br /> � .,; �' ,,� iti l ' ��_► �`�" �' �Q• <br /> c ��� r c ,.�-�``I ` � �'��� `� �" �� � r 1r-, - �,/.� \_ <br /> � r <br /> . , ,(_'�� � ` � P .� ,�,(� � �-� ` j'.� <br /> I �� t� � � i ��,i.�:. � � ` �f c� � � rL�'. <br /> �, l"� '� 4 r ' �l d� `' `' T <br /> ' F� � '-�� <br /> � � ' ':�� ' ' ''' ` �� ��'/�'_`�') SC�' �' ,��/r.�,... � <br /> I �e oRivEwar sEcnorv <br /> PERMIT IS VALID FOR 60 DAYS � ---+I <br /> COPY OF THIS APPLICATION TO BE POS7ED �i" LIP <br /> ON JOBSITE. 30" �- ' 30" <br /> CALL FOR INSPECTION 259-661 1 <br /> 24 HOURS BEFORE CONSTRUCTION �he un0ersignetl owner hereby a9rees to holtl antl seve harmless <br /> Ihe City ol Everetl 6om any antl all cleims br tlamages, cosis. <br /> ' eepenses.or causes o�action Ihai may aiise because ol installalion <br /> antl mamtenance ol Ihe imprOvemenl or olhCr nghl-ol-wBy u5e <br /> hereto apphed fo�and lu�in;r agrees 10 rem� �same upon noI¢e <br /> irom I�e Gty and �o replace publ¢ propetly Oamagetl �hereby <br /> DEPARTMENT APPROVALS <br /> � SEWER COMMUNICAT10��5 <br /> ORAINAGE TRAFFlC ` � .�" <br /> � . ,. . j�. .i _ <br /> NATER ( PLq I SIGNRTURE Of APP���AY� <br /> �n� � � 1.�, (� % i �. !; . � _ .. /-� � <br /> M� ',(� , �1� �_ h " AODRE55 ,—� <br /> STPEET :� . ' _ <br /> �"-i � <br /> ; �� �_ �..y,—/ ��.. _ - �Z�P <br /> J1PPR0 � ONSTHU •- .., -� . —/ -- J <br /> .. ...�tE lEl[PnONE NUMOEB / RLtERNni[ <br /> �,-_..... ��� . �� .�r� '� ���� ! i �" `� _ <br /> APPROVEDASCONSTRU � ^. r�:°��f ��, � OAIE DniE <br /> i.i <br /> � Ih!ITI�ILIDlSP�CTIONRCQULSTGD �EE t978 <br />