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,� . . . <br />- e�e.en ' <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or pnnl clearly wi�h ink <br />PRESS HARD - YOU ARE MAi<ING COPIES <br />PUBLIC WORKS <br />EYERETT. WASHINGTON ' PERMIT NO. � `�D <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: N� ��G�/'�M �!GL� �dEk S 1 UC• <br />HEFEBY,APPLIES FOR PERMISSION TO ���vF �"� �� A e e Fss 7"rJ Y� � <br />AT THE FOL OWING LOCATION SC% D S A— T SO «��S <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SE W ER <br />pliAINAGE <br />DEPARTMENT APPROVALS <br />co�+�wwcanor+s <br />t RAf RC <br />\4ATEN 1'/�� � I PIANNIN�� � . <br />III � tll ✓ .. ' <br />i <br />l__ — <br />sr��EE, <br />`''�' lb' �` 7 S <br />PROVED POF CO TR ION ���-� � OATE <br />".p.:-� ��) �I j �.� <br />L + i C?'; � P� �'S¢'$'�"� <br />l%� 'r�� <br />J��:: f11� <br />qPP V AS CONST UCTED DniE <br />CONSTRUCIION/AS 6UILT <br />3'�� �� �' <br />DRiVEWAY SECTION <br />+I" LIP � <br />�30�� �30� <br />T�e undcrsiqned owner hereby ogrees to holtl entl seve hermless <br />IOe City ol Evereit irom ony nnC ali clnims br tlamages. costs <br />espenses. or causes ol nclion Ihal may arise beWuse ol insiBllabon <br />antl mamlenancc of t�e impmvement or ulher nght-ol-way use <br />hcreto applwd �4� antl lurihei agiecs lo remov� same u0on nohce <br />�mm Ihe C�p• and to �Cplace public prope��Y demnr^tl ihereby. <br />�� ,� �� d� Qu , �EK J p� <br />L� <br />SIGNApiU11E O� APPL�CANi <br />�/� �.7 SO CCN �V /Eul .d.NAiif� <br />pS,�,qivu� a a c� %l�ct 9� Z Z- <br />��,� L�� <br />�s2-9�97 <br />iELEPMONE NLIM�ER AUERNAiE <br />OA1E <br />1978 <br />