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everen <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or priCt clearly with mk <br />PRESS HARD • YOU ARE MAKING COPIES /J� <br />PUBL'iC WORKS 7 �.CO <br />EVERETT. WASHINGTON `� �� PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANV: <br />HEREBV APPIIES FOR PERMISSION TO <br />U <br />AT THE FOLLOWING <br />%i <br />DRAWING (WORK TO BE DONE) OR THRE�PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF 1 HIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />n� i�:nveo ns coNST�ucTeo o"+E <br />X <br />CON�;I-f;IIc:TIOiJ.,. �: rl.�l.T <br />DRIVEWAY SECTION <br />�" LIP <br />�30� T �30„ <br />The undersigne0 owner herrby egrees to hold antl save harmless <br />Ine City ol Everett from any anE all claims �o� oemages, ws�s. <br />eRpenses. or wuses ol aclion Ihaf may anse because ol installation <br />antl mainlennnce ot Ihe improvemenl or oiher rh]nDo��way use <br />nereto appLetl br an� �urther agrees Io removc same upon not¢e <br />Iro�� �"^ C�Iy anG to mplace Oubbc O�operty Oamage0 Ihere�y. <br />/ <br />SiGN LaE t no��icANt / <br />�_S'v 3 7J`/ ��< .�,,,�C rY <br />nODAESS <br />�� �a�,. y2uz�,�,�1 a,-2g z.�.3 <br />�-���"a <br />iELEv���4EN�A'E�l�� n�iC�r�n�f <br />C.2� �` � 6 z9 <br />�A,E (�I e h c <br />, , F 197f3 <br />