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I _ � ��� � <br /> everett <br /> Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � Type or print clearly with ink <br /> �� PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS <br /> EVERETT.WASHINGTON PERMIT NO. � � —�O <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: <br /> HEREBY APPLIES FOR PERMISSION TO �N..�i���L(�� /J/l� rY .J�;n' <br /> ATTHEFOLLOWINGLOCATION 2ZID— IvIO/J/'OC Ave - Eva.o71` LlJCL ��ZO� <br /> � <br /> , � <br /> ORAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> //,.7' �0.2,—/Cn/ Or <br /> /�iL�/v.iwil7 l,�iTi�/inl �/l-/�� 0�= <br /> /tis1� /r)c/5: P�.r /�A✓if 0, <br /> I � ' DRIVEWAY SECTION ' <br /> PERMIT IS VALID FOR 60 DAYS � ---.i <br /> COPY OF THIS APPLICATION TO BE POSTED � + i" LIP <br /> ON JOBSITE. �30'� T� .�-r3o��.,� <br /> CALL FOR INSPECTION 259-861 1 <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned ownen c�reby agrees to holtl enG save harmless <br /> I�e Ciry ol Everetl Irom any antl nll claims lor Oemages. costs, <br /> expenses.or causes ol action Iha�may arise because ol mstallalion <br /> antl mamtenance ol Ihe Impmvement or other nght-obway use <br /> hereio apPlieO lor an0 lurtncr ag�ees to remove same upon nouce <br /> Imm ihe Qry and lo rep�ace publm properly Oamxged thereby. <br /> � DEPART:v1ENT APPROVALS <br /> SEWER " � '',� ��•:i '�. '_�'� �. .COMNUNICATIONS <br /> �1 V ... .. . . . <br /> DRAINAGE ' TRAfFIC �y(I�}�,� <br /> r{�Y� i... rt'� 1 �(lU'���t, �� � l.V" <br /> i' <br /> WqTER VLANNING SIGNATUR[OF pPPUC/Ni <br /> ...... . _: .;_�,�, _ iuvvf t��SNin�,iunr ��nv !� y <br /> STREEt <br /> _ j;�`;1 ��.� � nooness <br /> t�,,az,�,,;;: :�i��;°� �-f- �cla 9kZ� ol <br /> /� �V Im <br /> (// ..�ti�� 3 /_ / citr <br /> pppqp�� CONSTRUCTION T L(�.� '; S S— IZ1 Z <br /> 1!��('r�nNC ryU!�9ltt A1 t rnN�lE <br />