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, <br />�" 8� / �cz� <br />U APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or prinl cleatly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS PERMIT N0. �' � �^ <br />EVERETT, WASHINGTON . /1 ^ <br />T/+n�e �A�PS S.�iNc � I�NST lo <br />APPLICANT (UNDERSIGNED) AND FIRM PEPPESENTED, IF ANY: � <br />HEREBY APPLIES FOR PERMISSION TO ��= C � X S i%� N 4 <br />('?A(/rL D�� ✓rwAy <br />AT THE FOLLOWING LOCATION <br />SgaG S � ^'—`� Eu�a�tt cJGs� <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTIOaI 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWEP <br />DfiRiNFGE <br />WAlEf1 <br />SIHEET <br />DEPARTMENT APPROVALS <br />GOMMUNiGATiONS <br />JqAFfIC <br />PLAMMING <br />____�� -G� - �... � ��7L %t"� <br />nrra eo ro coNs au TieN� <br />(�.��-` �>`. ^ _ -- �_��I���� <br />DRIVEWAY SECTION <br />� I" LIP <br />I 30" � � 30 <br />The unEersignetl owner hereby agrees to holE and save harmless <br />e�penlses�or cruses ot clion Ihntl• �ay a�ese bewuse ol 9 stalCatson <br />anE main�enante ol 'he impiovement o� ol�er ngM-ol-waY ��se <br />herelo ap0��ed �or an0 �utlhe� agrees lo �emove same upon nolice <br />Irom Ne City and lo replace pu�Lc p�operly Oamaged tM1e�eby. <br />�A�id A. Nt�s'o� <br />C� 1 � G' �'L�- <br />SIGNATUR[ O� A�'�'�ICAN� <br />G S�� i7i srAvP S� <br />AOOAE55 <br />oNa�^o � r/3.290 <br />GTV •• <br />SG8 -VG/G —p�,Ea�A,E <br />iCL[��'O`+E NUMpER <br />3 -z y-8/ --- <br />