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everetl <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON ( PERMIT NO. 7�^ � <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: r!` 1 L� �'l1�'� �, 1�Z '� "/ �'luu 1 P✓ <br />HEREBVAPPLIESFORPERMISSIONTO (�".VI`�1 /VC� v'j Cl�•/Il�1"�� C�/i�U ( iill' J I�jd.)%!)/1�'iuf,« 1 <br />7' <br />r\� I <br />AT THE FOLLOWING LOCATION � r� Ci � V� �' (� c���, <br />DRAWING (WORK TO BE OONE) OR TFIREE PLANS ATTACHED: <br />r � <br />= � <br />•� <br />S L r <br />� —i.. ��r ns ��ss.z ...�1��1_'O-L '�dN (��l�Q , <br />� [iyO��w��'IOV�e�^�^^i Ir.t2 <br />� � <br />--r' s <br />� N i <br />c _'y' <br />� A �s s a ��o = - <br />� Z �Ot,2.��c1 IN[IP,�I�I'k,N✓� <br />� <br />. `--- 2 �' _ I' <br />CLiS� � <br />Wee+ � <br />q,,.5� . n � �5t,o�� r„cl� <br />. __ _ �_�_ �_�a <br />'e�e�a,���s� be Cs � �1 <br />,�''� _ ��t b� C,{�1 I�s��ac{�r ,�, �e1�i <br />( '� i <br />��` . <br />PE� IS__IS YALID FOR 60 DAYS <br />�� <br />COPY OF THIS APPLICATION T��$E POSTED <br />4�N JOBSITE. <br />�CALL FOR INSPECTION 259-B81 1 <br />�� 24 HOURS BEFORE CONSTRUCTION <br />_` <br />DEPA7TMENT APPROVALS <br />SEwER <br />DRPINAGE <br />V.ATCN <br />STREEi <br />; ✓ 11 �l, <br />COM6NHiCA1iON5 <br />v� qryNl 14 <br />. �^ <br />ORIVEWAY SECTION <br />f•---_; ..l 1.���---� <br />I" L--- � P — <br />I 30�� i �: 30„ <br />�� � <br />The undersigned ownen c�reby agrees to hold nnG save harmless <br />Ihe Qty ol Everett iwm any anE all claims lor damayes. cosls. <br />eMpenSCs, of edi5e5 0� atli0n Ihal may an5e bCcduse of insl011a�ion <br />nnd mainlenance ol iM1e improvemeni or othcr nghPot�way usc <br />he�eio np0��ed br and Iml�cr agrees �o remove samc upon nolicc <br />Irom t�e Ciiy antl lo rept3ce pu�Oc properly tlamnged IM1eieby. <br />X � �4..� <br />SIG 1 Il1E Of AP �Nl <br />u)O a ;' � 1�,,r �d U <br />n n+ess � <br />�_ �„�.;� �.1�-- 9�'�O � <br />