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� <br />gyeretl <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />� Type or print cleady with mk <br />�� PRESS HARD - YOU ARE MAKtNG COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON ` n PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: / 1LJ�� Y� ��Ti` (�u,' <br />n.,r�n..� � 1� c- 17.n Jr_ ^�� /i ��Y ��li <br />HEREBY APPLIES FOR PERMISSION TO <br />% T. <br />AT THE FOLLOWING LOCA:ION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />e �� cRie�aL� �r���.�-�s��l �a�e �rus�'��7z�ci <br />d�,B�r�'� r� �Q�b�. P��9cc�xl'T —��q � 1( <br />Rl�� uIi b i y ��l <br />�e ���Q � � <br />79', g/ � <br />�-� <br />PERMIT IS VALID FOR 60 DAYS <br />COPY QF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-SB 1 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />APPROVED AS CUNSTRUCIED �'�E <br />DRIVEWAY SECTION <br />� I" LIP � <br />� <br />�30�� _ _�30�� <br />The unaersigned ownen c�reby agrees to hold end save harmless <br />the Ciry ol Everett 1mm any and ail Uaims lor eamages. costs. <br />eepenseb. or causes ot act��on I�at may anse bewuse ol mstallabon <br />and mainlenance o� thn improvement or othei ng�4o�-wny use <br />hereto aGobe� b� and luriner ag�ees to remove same u0on notmc <br />from Ihe Cily an� to �eoi�c� v��ni�� propeiiy Oamagecl Iherehy. <br />SIGN41l;��� ��� _-- _ <br />L1V�2�J� ,Y= = J—�' _ <br />AU[1N6t <br />��.��f-- 1,�..�. 9 �r�U I <br />,-„ � - Z�„ <br />�2 5'� -3 / G I nitEnNnrE <br />ilLE�'��ONE NUAIUCA <br />�—�7'�9_, <br />pn�� <br />'�Frri���r��-r_cor��r ���- <br />—_'_- _ �9/8 <br />ii <br />