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everen <br />� <br />APPLICATION FOR RIGHT-OF-WAY USE PERA9IT <br />Type or print cleArly wllh mk � <br />PRESS H/1RD - YOU ARE MAKING COPIES <br />PERMIT N0. 71 �� <br />PUBLIC WORKS <br />EVERETT,WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIqM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION 3�� I I��G 5,S 4 G� S�' <br />DRAWING (WORK TO BE DQNE) OR THREE PLANS TACHED: <br />B�27CoM�� �-���}f:,�e w.�� ✓ s � �� <br />�/' r%�l N% �Y�VP Wa� t'e✓ Go � <br />(3 � 7'��rc<' de-S���r.-.�rS. <br />2 � y 2 8. 7 D 6 � ,, s�-� <br />Po���e oF �7d,e�lF'y ���ro�-b �a�vc � �.i� ��v s� � <br />,yQ r� � �b,Pr� -.�W�'•s' �9�Y,� <br />.�-�,�odiD� �o�i�s o F�i55����Ts T� �a ?S z 3� zy z5� zG� � <br />� T� z8 Fi�o� �a T 9; <br />FRaevl � rs z�� z6 <br />�� <br />� <br />/}t ����ilt�itl T TO �d r5� Z7� �g <br />I� `�°" G�°��1 <br />,r�� � ,I� I'�yQ"" <br />v � ss N� �� s�r <br />� /� . -o r� v <br />� S <br />I� 1 <br />�' D �' � � � <br />� � � <br />S� <br />�e U <br />� <br />�� � � <br />/'� <br />PERMIT 'IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-681 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />GOMMUNICATIO: . <br />TPRFFIC <br />PLANNiNG <br />STPEET <br />� � ��� <br />A ED FOR CONSTRU I � E <br />DRIVEWAY SECTION <br />� � <br />I" LIP <br />30" _ � _ 30" <br />The undersigned owncr �ereby agrees lo holA ena seve hermless <br />the Ci1y ol Ererett Iwm any anE all claims for Gnmages, cosls, <br />eapenses, or causes ol aclion IhAt may anse because ol mstallatmn <br />antl mnintenance ol Ihe Improvement or other nghl�ol-way use <br />herelo apphed lar and luriher agrees to remove samc u0on nolice <br />irom 1he City ana to repla[C pubhc prope�ty Oamagetl Iheee�y. <br />�. ' <br />51 AiURE OF APPLIC�NI <br />TELEPnONE NUM1IpER AL�E(INr11E <br />