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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print eblirly wit'i ink <br />PRESS HARD.- YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON l PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY: -- - <br />HEREBY APPLIES FOR PER. IISSION <br />AT THE FOLLOWING LOCATION —_3 _5--,r2 I yb <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE ^OSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-86 ', 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWER COMMUNICATIONS <br />DRAINAGE TRAFFIC <br />STREET <br />PLANNING <br />�L <br />C O C1 <br />DA E <br />CONSTRUCTION/AS BUILT <br />DRIVEWAY SECTION <br />I" LIP <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 righbof-way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged the, <br />IELEPNONE NUMRE ALTERNATE <br />12 -z - -1 <br />DATE <br />1978 <br />