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everen <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print claerly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WOHKS <br />EVERETT, WASHINGTON � ' �-� �MIT NO. �'-�'� � ��- �� <br />� /� <br />APPUCANT (UNDERSIGNED) AND FIRM REPRESENTEO, IF ANY: V�'{-' � � ul�'�-"� <br />HEREBY APPLIES FOR PERMISSION TO `J�r��T � �'� � F �oT ` P,,�'�Fl �' I' F AlC E' <br />. � . . <br />Aho��- ,S ��e w�►�,.�� � ti C rr�r �Z'AS/7�E'NT -� r ic� iN �f�„�o . <br />AT THE FOLLOWING LOCATION I J(. JO �� I V�� i L 1'�O �It, V�U • <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />��1�%��lr7t%Ci I�I.I/D <br />Sin2 [�,n � k <br />�oTi�O (�1c�2. <br />�h� <br />_ -� 3 �T \ <br />CtioA*� <br />--��' Fe�JG� <br />i ,"0 S. <br />yY�un ��.:v <br />�= t.c:G:eR,. <br />�['je n <br />►s C� � 1-� �nsemP�-r <br />PERMIT IS VALID FOR 60 De"- <br />COPY OF THIS APPLIC/►'�'��^' r� BE P�STED <br />ON JOBSITE. <br />CAL2 HO R BE ORE CONS RUCTION " <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />SEk'ER <br />TPAFiIG <br />pppINAGE <br />FLANNiNG <br />1YATER <br />$iHEET <br />/i , � �j , j �'/G/S�— <br />onrE <br />qPPROVED F CONSTR�ITCT�ON <br />qPPROVED AS CONSTRUCTED <br />pAtE <br />PEFERENCECOPY <br />y.n <br />DRIVEWQY SECTION <br />I <br />I'� LIP <br />30'� <br />30" ----^f- � <br />T�e undersigned ownor �e�eUy agrees lo hold en0 savo harmless <br />Ihe Ciry ol Everetl Irom o�Y antl all cleims lor dameges. co51s. <br />antl ma ntennncecol Om1imPm?en entAoreolher�ungh4ol-weY 1� se <br />Irom �ihe C ly a�rd to rcplaceapubl c p�o� e�iy dnmage0�the�eby <br />,; <br />� � �' <br />� �'/. L:�� <br />fUAE OF APPUCANi <br />r fl <br />i /%�� 1���, <br />r� <br />; / <br />� � <br />' ;:G �'l ' <br />\ i.� <br />I�'�<�i% _5 <br />'�•_y �i�(k, <br />; <br />ALiERNATE <br />TELEVMON� NUMBE(R� � <br />`� G l /� _. <br />� f �+.,, -r,.. �. �-tv. . .. - _�.. . ... _... <br />� �j-'::i . . _... <br />