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i <br /> Ievereq <br /> I � qpPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or print cleady wilh mk <br /> IPRESS HARD -YOU ARE MAKING COPIES <br /> PUeuC woR�s PERMIT NO. g� �� <br /> EVERETT.WASHINGTON /� <br /> APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY: <br /> ��Jc�-!�'A `f��'��L <br /> �' �c�Z, c <br /> HEREBY APPLIES FOR PERMISSION TO �� <br /> AT THE FOLIOWING LOCATIOt� � �� U Z" � � <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> I <br /> . <br /> � <br /> I <br /> I <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAVS � � <br /> � COPY OF THIS APPLICATION TO BE POSTED i" ��P�— <br /> 30" 30" <br /> ON JOBSITE. ' <br /> CALL FOR INSPECTION 259-861 1 <br /> 24 HOURS BEFORE CONSTRUCTION <br /> The undersignetl owner hereby egrees to holtl and save harmless <br /> Ihe Cily of Everetl irom any end e0 tlaims lor tlemages, cosls. <br /> expenses,or cnuses ol ad�on ihat may Tnse because ol installal�on <br /> � and maintenance ol the improveme�� or other nghl�obway use <br /> hereto aOP��ed br and�urt�er agrees 1Oro er�t c Oa ne9eaothe eby <br /> irom Ine Ciiy ana to �ePlace Oub c � P Y <br /> DEPARTMENT APPROVALS <br /> GOMMUNiCAT10N5 <br /> SEWER <br /> '11 C,ltiLr}'�� !_ <br /> . . . '� ',�. I TRAFFlL /� ���Iif/ <br /> pfiAINAGE - - /�" <br /> ""�: '11 �� ,' - SIGNATURE OF APPLICANi <br /> WAT �� 1 ;:7 . �. ... ' '�� PLRNNiNG + �� � �� <br /> l /o a o z ��c�✓..�.._.- <br /> L(�1/"V--� <br /> nooAess y- J� Z G �/ <br /> �STRE 1 � G•. �V V ��•.1/✓ -/L i� ZiP T- <br /> 7_Jv�� ci.v <br /> � 3S3 -��59 <br /> 1 DATE ALtEBN/TE <br /> q O _ -R N /Y TELEPHON[NUMOEA <br /> � � ZG� lf�G �! �— / �- �I <br /> r ��� ��,�� , <br /> `�� ' _ _ L•`i PaTE <br /> � 0 � - " __ <br />