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everett <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS 79/ <br />EVERETT, WASHINGTON PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY:_y 157 <br />4 <br />HEREBY APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION = <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />4 <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 255-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />WATER <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />� V <br />TRAFFIC <br />PLANNING <br />CO,hCrt <br />DRIVEWAY SECTION <br />1' LIP <br />r 30'�T 1 _30" <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages. costs, <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other righl-ol-way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged thereby. <br />BUILT <br />FEE 1978 <br />