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evereM <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Ty, � or orinl clearly wilh mk <br />PIIESS HAHU - YOU ARE FAAItING COPIES <br />PUBLIC WORKS 7 C '7 <br />EVERETT, WASHINGTON PERMIT NO. L <br />APPIIC! VT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />I <br />� HEREBY !•PPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOGATION. 'S / �I /T —� ��«f� � ^ O /� �P � <br />DRAWING (WOF,K TO BE DONE) OR THREE PLANS ATTACHED: <br />�L�s�'� �� `� /�i�ff.�G � /� � -� -1� <br />. <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOB3ITE. <br />CALL FOR INSPECTION 259-86 Z 1 <br />24 HOURS REFORE CONSTRUCTION <br />Sewm <br />DRAINA4[ <br />DEPARTMENT APPROVALS <br />COMMUN�CAii0N5 <br />iFFFflf. <br />yyqT[q VLANNIIIG <br />CTHFFT <br />CGNSTFiUCTION/AS BUILT <br />DRIVEWAY ScCTION <br />� � <br />�I' LIP � <br />�30" 4 } _+30,. <br />The untlersigned owner h^reUy ngrees lo holtl entl savo hermless <br />Ihe Ci�y ol EvereY Irom any and nll claims lor tlemages, wsis. <br />eRpenses. or cnuses o� talion 4�nt may anse because ot ins'ellation <br />xnd mflin�en. nte ol I'ae improvemeN Or ol�er righLol-wny use <br />nerelo apphcil br nnr, Iutlher ngrees Io remove same uL�� �Olicc <br />Irom Ilre Cily ano IJ �epla"e publit pw0erly tlnmagcA mereby, <br />� <br />I I � �. / <br />�,a�.�A o� AL,��A�`�tncFlzei <br />3��✓-7/ �_F <br />nooncss <br />Ma,r�sv � C.l � `ifr� p <br />��✓ 3 �_ �./�. 0 9 ;::P <br />LELEPI101�[ NUAIpEq /LIEPNAiE <br />I✓oZ•• 2 7 - l �7 ) �f - <br />DA1[ <br />