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i � <br /> rr ,en <br /> . Q APPLICATION FOR RIGHT-OF-WAY I�SE PERMIT <br /> v Type or print cle�rly with ink <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS - <br /> EVERETT,WASHINGTON PERMIT NO.79�/3�� I <br /> APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: � � L%/0� <br /> / <br /> HEREBY APPLIES FOR PERMISSION TO / S • I�G piQf✓� f.(f �y <br /> AT THE FOLLOWING LOCATION 2 (+`'� I'J�//��D� /J l�� <br /> DRAWING (WORK TO BE DONE) OR THa`LANS ATTACHED: <br /> DRIVEWAY SECTION <br /> PERMIT IS VALIfD F�DR 60 DAYS � � <br /> COPY OF THIS APPLICATION TO BE POSTED i" �IP <br /> ON JOBSITc. I I <br /> CALL F(?R IDiSPECTION 2�'9�-�381 1 1�30 T -►} 30�� <br /> 24 HOURS BEFORE CONSTRUCTION <br /> 7he un�ersigned owncn c�reby agrees to holtl Antl save harmless <br /> Ihe City ol Evereli /rom any and all claim5 lor tlamages. cosis. <br /> ecpens��s.or causes ol aclion�hat may:nse beeause ol inslailahnn <br /> an� mantenancr ul Ihe unprovemenl ar olhrv nqhl-o��wq use <br /> bnr�o ap{:bctl Ic.r an� Iur�Opr ,�gioeu Io remove s�me vpon noLC^ <br /> DEPARTMENT APPROVAL� �iOi" �"^ C iy a��� �o �epiace n��t•nc p�opr�iy �a���agea mciei�v <br /> SEWER WAIMUL�,.II�Oqs ���� <br /> OBAINAGE TqpiflC � � <br /> � <br /> ., d S 2 �ci�� , <br /> lV���F i CLqhNING S GNA*U�IE OF APPUCANi <br /> �� ' ve� ree w <br /> SiREET - npOn[5,; <br /> i (i, -��� � � �.��L�C'�G/ f� O.� <br /> ��-�.�ne..� � - �a-7 :_ . z�P <br /> A Pq VF D FOR CONS UCTIO cntE _ ,� r��� 7 � ('�(��� <br /> �l ] J <br /> l� �G� • 1ELCPHON[NIIMB[R AUENNAfE <br /> �� 1 V v. <br /> -a � y-�.�-�y <br /> O ' A C HSTRU ED DnIE DnIE <br /> � C^��19T!�UCTIONi �,S L'UILT FEE — <br /> 1978 <br /> � --- ,. . _.^r:... _ .., .. <br />