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i � <br />� <br />a <br />everen <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly wlih mk <br />PRESS HARD - YOU r.RE MAKING COPIES <br />PUBLIC WOqKS � <br />EVERETT, WASHINGTON . PERMIT NO?�'ZB 7 I <br />I <br />�/l'flj/( %'(._,.���,(/ i, �-:;( (C.� <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: _ � <br />; � �;— � ; . , �- ,_� - r'���� r ; - L),r �V - , �fi � ' <br />yEREBY �PPUES FOR PERMISSION TO_ - � �� - c_ ( i � <br />AT THE FOLLOWING LOCATION <br />R µi /% !� ✓' � � <br />DRAWING (WORK TO BE DONE) OR TFiRf'E PLANS ATTACHED: <br />,,, •i <br />i r_. <� _r �t_ ':... ;- � � .. :: l dr' /: , :c::: <br />� <br />I� - � i �� r- LC; ;'� � <br />� <br />G�� � e� <br />C� / � � �'� o`�' � � t <br />I;/C �,1 � f c~' S� r^ <br />5 <br />� <br />L <br />r ��� h� �E <br />/�', - �e µ ��� �a� <br />r1e`� �5 � �� /i <br />� �,�'P � l�'/!� <br />! <br />PERMIT IS VAILID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JI�BSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />ER <br />DEPARTMENT APPROVALS <br />coa,nwwcn <br />n�pNWNG <br />�n 7�7��2���i��j� <br />APPROVEO FOR CONSTR il0 // DAL <br />APPROVE� d5 CONSTHUCTED �/iE <br />CONSTRUCTION/AS BUILT <br />DRIVEWAY SECTION <br />I -- ---I <br />r�- t I" LIP � <br />L30_�___ �30" <br />i- <br />The untlerslqned owner �em0y agrees lo hold anC snve harmlc55 <br />Ihe Gty ol Evemlt irom any antl all elaims /or Oamagas. cosls. <br />eMpenses. ar cduses ol aclion t�dl mtiy anse because ol mstallalio� <br />ancf mnin�enance cl IhC improvCmeni Or olher righ�-ol-w0y u5c <br />hMelo appLetl lor ind IurlMr agreCs to remove 5ame upon nolice <br />Irom Ihe Gty ancl to replace pubhc proV�`rIY tlama9ed inere�Y. <br />r"��.. _ � � . <br />,r • ` <br />_,,. r.._ -.�P�, <br />516N4TURE OF APVLICANI 7 <br />.. �. . C- ." j�'`' I `'r/ c,�V� <br />C. . <br />noouess <br />, <br />�' � " '? � 1' iC f <br />I;11 V I�P <br />'-c._ : %� l � � .��r� <br />*flE���ONE NURIOCR AUEHN41[ <br />r.t I � ? <br />onrE . <br />— � <br />t <br />