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' �� <br />' everen <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />� <br />PUBLIC WORKS <br />EVERETT, WASHINGTON <br />Type or rrint clearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PERMIT NQ ��! �./ � <br />APPLICANT (UNDERSIGNED) AND FIRM iiEPRESENTED, IF ANY: �O � t�, C O• _�«�' ----� - <br />HEREBY APPLIF.S FOR PERMISSION TO -=NS r 1I I� .3C� C Oruc Rt 7� D R I V C� <br />AT THE FOLLOWING LOCATION � ~ � � �v � �l� 1 r �� ° ���`� r <br />DRAWING (WOHK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPitCT10N 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />D�AINlGE <br />WATEP <br />STREET <br />DEPARTMENT APPROI/ALS <br />COMMUNIC/ T�ONS <br />iRAFFIL <br />PLANNING <br />APPROVEOFOR CONSTRUCTION OaTE <br />�APPROVEDASCONSTPUCTED OAtE <br />CONS7RUCTIonlns Bu�� T <br />DRIVEWQY SECTION <br />� � <br />j I'� LIP <br />i <br />�30�� _I_30„ <br />�r- <br />The undersigned owner here�y agrees to holtl entl snve harmless <br />Ihe City ol Eveielt Imm eny and all claims Ir� demeqes, cosis. <br />enpenses, or CBuses ol aciion Ihet may arise 6eceuse ol mslalla�ion <br />and maintenance ol ihe improvement or oihe� righbobway use <br />ne�elo appbe0 lor ontl funher agrees Io remove same uoon nobce <br />Irom Ihe Cily antl 10 replace pu�lic properly tlameged Ihereby. <br />,A <br />�,.. lYJ 1�-.,a..,' .,.:zt. <br />SIGNAlU�EO AW�II nNi <br />� �r o2035 <br />nooness <br />�✓E��F-iT" i82o3 <br />CITV ZIP <br />,3J%- .2=f.2i� <br />LEt[V9�ONE NUM�ER ' RUERNAtE <br />���%2 7�79 -- <br />onrc —7— � <br />