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i IIVa•illl <br />1 <br />,e <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or pnnt clearly wM1h ink <br />PRESS HARD - YOU ARE MAKING COPIES I <br />PERMIT NO. / 36 I <br />PUBLJC WORKS <br />EVER�TT, WASHINGTON <br />'i APPL�CANT (UNDERSIGNED) AND FIFiM REPRESENTED, IP ANY: <br />i HEREBY APPLIES FOR PERMISSION TO <br />�41� <br />AT THE PULLOWING LOCATION Y I� �i <br />I <br />� <br />DRAWING (1NORK TO BE DONE) OR THREE PLANS ATTACHED: <br />.�e d1%-(�� �I �s <br />/ n//� <br />S� �� <br />G`�' <br />�.v�"f <br />��e <br />/y 3/ <br />% ''� � �— �` � ,� <br />.,,. f� ..�� <br />. ��' �'q ,�^" S���,� . <br />C /� �O /' �°� � S 5 � V' J �� l, % � , <br />�� � �cC� � a cc. i <br />i� > �n�i , <br />Y � � c v / �� �.�— <br />PERMIT IS VALIO f=OR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POST�D <br />OV JOBSITI_. <br />CALL F�DR INSPECII'ION 259-881 1 <br />24 HC�URS BEFORE CONSTRUCTION <br />I <br />SEWER <br />�4nINRGE <br />IWATEII <br />DEPA�2TMENT APPROVALS <br />DRIVEWAY SECTION <br />I" LIP <br />�30" _ _I_30" <br />T�e untlersigned owner here6y egrees lo hoid and seve �armless <br />ll��ity ol Everetl imm any antl all r,laims lor Oamages, cosis. <br />+4+qse5 ur causes o� ac�ion Ihat may anse because ol installabon <br />an0 ma�ntenance of ihe improvemen� o� othcr ngh4nf-way use <br />�n lor ana Iuriber ag�ees lo remove Same opon nohce <br />I� he Gty and IO replace puhhC OrOper�y damaged Ihercby, <br />1 <br />COMMVNILATIONS �ilVl � � ��a <br />TRAFFlC ^,^, <br />PLPNNING <br />i � � <br />' � � /' /� — (��> <br />I P O D FOR 5T U( TIO/N OniE <br />i / /j / <br />I � R� 5���..�/ /.v�o� �� � <br />c <br />I � <br />1 -i� > c ���� <br />{r � .Ary� <br />�� N �� <br />N � I'�� <br />I,� a/_ 11�. i�! d'-I-�„' <br />1ELEPHO �M1IBEq � <br />1 <br />U41[ <br />CONSTRUCTION/AS EiUILT �EE <br />AL ;iNAiE <br />t <br />