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ever2n . <br />ApPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />� TYPa or print clearly with ink i��� <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS ` A <br />EVERETT, 1�VASHINGTON PERMIT NO. 7� �7� 6 <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY' ���C `-�"���^"""""' C� ' <br />i� / <br />HEREBV APPUES FOR PERMISSION TO— �' ��"S /� �� �� / `-��� G � C !�—� <br />/.It� u /z,;,�/�c o <br />��o� <br />AT THE FOLLOWING LOCATION _L <br />.� —. ; <br />�—.�" �.>, _ �^,`r c� <br />�–�'�d- LyCli-e#' <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />�;c.� y�?c ;- �C�I N <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION �a9-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />1 <br />DEPARTMENT APPROVALS <br />� l <br />�' <br />�. <br />y=12 -� <br />DRIVEWAY SECTION <br />I" LIP <br />j' 30�►T� ri� 30,a1 <br />T�e urWeniynatl owner hereCy apresa to hol0 end eave harmNas <br />Iha City oi Everett Irom any enC ull claims lor Aemegea, coste, <br />eRPBnSB4. Of C8uSE3 OI lCtiOp �hBl RIly lfi50 CBClOf@ 01 If19�SII�liO� <br />antl maintenenc9 01 the improvemen� ar ol�er righ��ol-way usa <br />�eroto ap0lietl tor ana furNer agrees to remove seme u0or, noUce <br />Iroln'the City anG to replece pu�bc prodeny tlemege0 InereCy. <br />� <br />� r� � � , i ��`— <br />SIG OF AFPUCANT <br />�� d �OY .>'OC9 C� <br />A�DRE55 <br />�- � c. �7_'7` � �P�- v3 <br />LITY ZIP �. <br />CONSTRUCTION/AS'3UILT <br />��5 � - //�3�` " <br />iELEVMONaNUM P / � � qLiENN/TE <br />1 <br />��r <br />DATE // \ <br />Ndl1� <br />FEE 79�8 <br />._..____ _ ' _ <br />... :-.—. _... -.c:: hk ...:.._...r .__ _._.... <br />. . . . . . ....�nx.r'cC�! <br />