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_ . � 5'�i7 <br /> I everetl <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � TYPe or print clearly wilh ink <br /> PRESS HARD- YOU ARE MAKING COPIES <br /> PUeuC woRKs PERMIT NO. `� —�'� i <br /> EVERETT,WASHINGTON <br /> � <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED,IF ANY: '�I <br /> HEREBY APPLIES FOR PERMISSION TO �N���'�«- �i1i �f `��N <br /> 22/D- /'9a�roc /�ve Evaio7l`� l.�Jci 98Zo.� <br /> AT THE FOLLOWING LOCATION j� <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> I <br /> IU.iwi1vI !,/ii il.nl �/�-�fi 0.= <br /> ��`�! �OiJ:/Gn/ Or �� / <br /> /v�3�� /�7c�S� r7..i_ f f7✓rf D, <br /> � DRIVEWAY SECTION � <br /> PERMIT IS VALID FOR 60 DAYS �---- �'j <br /> COPY OF THIS APPLICATION TO BE POSTED �" ��P �3� <br /> ON JODSITE. I ao" I , <br /> CALL FOR INSPECTION 259-861 1 <br /> 24 HOURS BEFORE CONSTRUCTION The unEersigneE owner hereby egrees to holtl end seve�ermless <br /> Ihe Ciry ol Everetl Imm any and ell claims lor damages, costs, <br /> eapen5e5,or ceuses ol OClion Ihat may arise beCauSe ol inStallalion <br /> ana mainlenance ol the improvemenl or o�her ngno-ol-way use <br /> Immolhe Ciy aodato �eplaceapub�c1p�oper�ty Oamage��thee'Cy. <br /> DEPARTMENT APPROVALS <br /> SEWER ' `� �� -•COMMUNICATIONS <br /> i'� ( � .. ��.�I . . <br /> �, , <br /> O�AINAGE "J TNRFFlG <br /> . �-;-. /�c��r'�cc�j GJ � �'�'�_� <br /> IH�;: ' SIGNATUREOFAPP�iC�Nt � <br /> • P�ANNING I 1 '/ '1 <br /> WATER .. _. ....� IOLU� W/15M��1�.TUn� ��/�� /-� V <br /> • .... . �1.���� AD�RESS ''I /�C' <br /> STREET 1Y1.�.:'-� �'.1 �ilu', f �� < � (/�A' -f E 7 V `� — <br /> ' �0^fl G�try:. z P <br /> �y / CITV <br /> ("�7X'� �� � 3��— 3 5 5— I-L'1 Z <br /> APPR VED F CONSTRUCTION � A�E A�t[euAiE <br /> TELEPMONE NVMO[R <br /> .�� �i L — V �� Z ' Z3 — Sc► <br /> qp���� AS CONS C ED <br /> OA1E DATE <br /> CONSTRUCTION/AS BUILT FEE 1978 <br /> .>�+: <br />