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-� .. <br />• eve4en <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />� Type or prin� clearty with mk <br />�� PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS �n �-� <br />EVERETT, WASHINGTON PER��".� � NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HENEBY APFL�ES FOR PERMISSION <br />AT THE FOLLOWING LOCATION ���LO �r7'� �J��.�,�, �I <br />DRAWING (WORK TO BE DONE) OP. THREE PLANS ATTACHED: <br />�. <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTIQN 259-•�67 1 <br />24 HOURS BEFORE CONSTRUCTION <br />9 <br />DEPARTMENT APPROVALS <br />SEWER COMMUNICAiiONS <br />pRA1NRGE TRAFFIL <br />�, t i - <br />WATER '�l .YI . _. PUNNINO' �f <br />(>. � <br />STREET <br />n: <br />�i�� �r �, ,_. " _ . � �/ i���D <br />APPROVEO F CONS� u 1{WN." i} � i T D T�` E- <br />ii. „:_; <br />� . ..'�, i�:ti �I�'�t.� <br />APPROVED A �ONSTRUCTED UATE <br />IIEf=Cf��NCGC;OPY <br />DRIVEWAY SECTION <br />I � <br />I'� LIP <br />30" � --- �T�30��.1 <br />The untlersigned owner liere�y egrees �u holE end seve Ymrmleas <br />Iho City ol Eeere�l Irom any an0 ell claims lor Damages. cosls. <br />e�penses. or causes u/ action iha� may arise because ol installation <br />and maintenance ol t�e �mpmvem?nt nr olhpr ngh4ol-way use <br />hereto apO��eA br anU lurther aqrees to remove same upon nol¢e <br />irom t�¢ City ana to replece publ¢ property tlamagea Ihere�y. <br />� <br />�/i(��'. � 1 ( �. f . �� �� <br />SIGNAIUR[ OF RPPUG/•Nt <br />PDDAE55 <br />J�/�/ 7 � % <br />G- � c �,_ 7 f >t�'�: v� <br />iEl[PNONE NUMBER A�"ERNNiE <br />�'s'3- `i� %F <br />]-z9- �'G <br />�E� 1978 <br />