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y <br />, - <br />ev�.en <br />, � APPLIC/kTION FOR RIGHT-OF-WAY USE PERMIT <br />Typa o� pMnt CN�Ay wlth ink <br />PRESS AARD - YOU ARE MAKINO COPIES <br />PUELIC WORKS . . <br />EVERETT, WA3HIN070N , � � PE MIT NO._F��� <br />� <br />APPUCANT (UNDERSIONED) AND FIRM REPRESENTED, IF ANV:�.�`L ._= • /J'L 1/� <br />HEREBV APPLIES FOR PERMISSION TO �OAF_�'rQIJCT 3Foo-r (�PteR �e i'QAIC e <br />��� S,�ewfl�-� j� r �Tu gfl.�rnetiT ,� �iu iN eeN,�a <br />AT THE FOLLOWING LOCATION ��R �� I U�C 1 LT�U �Il, U�• <br />DP.AWING (WORK TO BE DONE) OR THREE PLANS ATTACiiED: <br />rn�1�LIc7CU <br />Ivew� <br />�'�uwe2 <br />�P <br />��T"rC�O {�lt>� <br />�-K <br />rs08. <br />m�K�a�o <br />PERMIT IS VALID FOR 60 DAYS <br />_3� � <br />Ce c���Q <br />� wwe� <br />�e� <br />� A S� YY� E �.1 'r" <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />C:ALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTIOPI <br />SEWER <br />pRAINAGE <br />WATER <br />DEPARTMENT APPROVALS <br />`1,n �I :til `�:, '.�� i � <br />U �7 �. T � _ �, J <br />` "^'(T��S-�'�. �tli ; '� <br />„ . �:. <br />. ,_ . <br />''St . �_' � _ . <br />ry�' ti' <br />COAIMl11UCAlIONS <br />TMFqC <br />PLRNNING <br />/� <br />CONSTRUCTION/:1S 6UILT <br />� <br />�� <br />DRIVEWAY SECTION <br />1'� LIP <br />� 30" ,� �L 30 "� <br />r- <br />7�e untlersignu0 owner hereby agrees to holtl antl seve �a�mless <br />Ine Qty ol Everett Irom any ane All claims loi tlameges, cosis. <br />CMpenses, or [8u5e5 0l aC11Jn Iha� m8y BrisC becAuse ol InStaIlB�ipn <br />dnd main�nnnn�e 01 I�e improvemenl or olM1er ng�l-ol-way use <br />hereto aophe0 lor anE lurther agrees lo renove snme upon nohte <br />Irom t�e Ci1y and to repince pubbc properiy �amaged IhereOy. <br />___ C L � �I �E/� <br />SIGNRtURE OF qVP��[p4i <br />� 1 %� . <br />ADDRE55 <br />��/�Pr� /,v.� >�'�O 3 <br />� v IIP <br />� �� �o� l�� <br />iEIEP ONE NUMBEAXR qLTERNRTE <br />� � � V � <br />t <br />K:_,r ^As:::y :..�'.'1..�� �. "*:�'u� <br />r � <br />