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i <br /> � eve�etl <br /> I Q APPUCATION FOR �31GHT-OF-WAY USE PERIUIIT � (�� <br /> I v Type or print cleady with mk /� <br /> PRESS HARD'- YOJ ARE MAI:ING COPIES � <br /> � PUBLiJ WORKS � /1 <br /> EVERETT, WAuHINGTON � PERMIT NO. �V °2 <br /> APPLICANT(UNDERSIGNED) AND FlRM REPRESENTED, IF ANY: I <br /> HEREBY AFPLIES FOR PERMISSION TO � �D�TiL�i e r Tw� / CQ/l.I C/�C� Z�•C� <br /> DR_t �cu�v9 y i�c1 Py1Bl�e ,�'��r/ i -a1=_l-�R� <br /> AT THE FOLLOWING LOCATION I�J A ' � �v 4 ��l �� 1 S / <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> � -r�P� ,b A,Fi u.�- �J� � <br /> � 5 ��� T /MP.�v!/r���J.i- TC� /Lfc,�T �a'/.si��t/l� <br /> LU� TI/ sr� TN 'T.�.'/;��1Jsi 7�D,U <br /> � <br /> I <br /> i � 5 T,�,� � S�"1�'i1J�/9re1� f��i�c�h�tJ> Ta �,�y�l/S- <br /> I <br /> � <br /> � <br /> � I <br /> I <br /> j � <br /> i I <br /> i � <br /> I DRIVF.WAY SECTiON I <br /> � PERMIT IS VALID FOR 60 DAYS � � <br /> i � <br /> � COPY OF THIS APPUCATION TO BE POSTED i�� ��P � I <br /> ON JOBSITE. �� �p <br /> � CALL FOR INSPECTION 259-881 1 I —�`i— +� 30 � <br /> i 24 HOURS BEFORE CONSTRUCTION <br /> � T�e unAarsignetl owner here0y agreas to ho10 eitl savo nnrmless <br /> I Ihe Cily ol Everett Iwm uny antl all claims loi damages. cosls. <br /> eRDmses.or ceuse5 oi action Ihai may anse because ol mstdllation � <br /> antl maintenance ol t�e imp�oremenl o� otl�er ng�bol-way use <br /> hereto appbetl lor antl luriher agrees to remove same upon noiicc <br /> Irom I�e Gty an0 to repla[c o��ei�� properly tlxmagetl thereey. <br /> DEPARTMENT APPROVALS <br /> i <br /> SEWER GOAINUN CATi0N5 <br /> pRAINNGE TqqFFlC <br /> WATER PIANNING ��� <br /> � SIGN4IURE Of PPVLILANI . <br /> � � �f C Q ` <br /> � STREET " —���( O /�S�.JT ,�� <br /> /DDRE55 �,./ -- <br /> I � P �jyC�,�l�� waa_/�_ _ / s �O/y[ <br /> .C,�• f� � cirv z��� <br /> APPRO D FOR CONSTRUC N onrE <br /> I ` 33�—�0 �.3 3��-6is� <br /> iCLE�'HONE NUMBER AL�E�NAIE I <br /> � fIUG <br /> 8o i/i�/&o <br /> APPR CONS 7ED OA1E opr � <br /> CON$IRUCIIOI�/ASC'_�UII_T �ti 1978 I <br />