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everett <br />� APPLICA710N FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly wrth mk <br />PRESS HAFD - YCU ARE MAKING COPItS <br />PUBLIC WORKS <br />EVEflETT, WASHINGTON PERMIT NO <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: �`��/� "� � �— • " <br />HEREBY APPLIES FOR PERMISSION TO�G ��� ���CTb �ti�C � <br />AT THE FOLLOWING LOCATION_�Q�7t' � "c�L"���//��! �L�F��T <br />DRAWING (WORK TO BE DONE) OR THHEE PLANS ATTACHED: <br />r <br />� <br />f <br />�dcK�rEi/E,` <br />� or.E'ac��frf//f�"' io ,-,<;�,��E .�� ' - <br />� 0.'= -3' !�/ /h � /.ENC� ..?c� i <br />� fvsl %v fCS � � � �CN��� j � ���� <br />PERMIY IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 9 <br />24 HOURS BEFORE COhSTRUCTION <br />SEWER <br />pqAINAGE <br />1VATE� <br />�, <br />DEPARTMENT APPROVALS <br />GOMMUN�Cn*iONti <br />tRRFHC <br />P�pNNMG <br />AI'PRCVED FOH GONSiNUCTiON Dn1E <br />,AvPHOVED A$ GON$TRUG <br />OA <br />DRIVEWAY SECTION <br />�I� j�l" LIP <br />�30,� f so�� J <br />T�e untlersigned owncr hereby agrees to hold anC ,avc harmless <br />Ihe City ol Everetl Irom any antl nll claims lor damages, cosis. <br />eapenses, oi causes ol action IhBi may anse beeause ol instaVaUon <br />;m� mainlenanCe ol IhC improvemenl o� ult�cr riyb��0�-�+'�Y ����' <br />I�r�clo aPVLcd br antllur�hr� OgrcrS lo mmove <nnm apnn noL.r <br />h�.n Ih�. CCY' �n;] lo oPlare oubLc 1`r..i�� .�.,i �,. ��u�.� <br />��'�� 7�LCc•�WYG�'�-_� —__ — _ <br />S�GNPIU�E O� A� iCANI <br />,�Crl �7 C�f..�N'o�/ ,�ci <br />nooaititi <br />� ST����s, ���/� r.�s f, <br />�—T- _�--�- - <br />�,,. <br />���� f1�3 �S�E,`Na3.�� " <br />iELE�'NUNE NUAIBEA <br />� <br />13�8 <br />� <br />