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everen <br />� APFLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or prin: cleady with ink <br />PRESS HARD - VOU ARE MAKING COPIES <br />PUBLIC WORNS <br />EVFRETT, WASHINGTON PERMIT NO. �.� �c�IcL�i <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: �%� 1' •���� C�N`J l I�UC. l I('l/�� <br />HEREBY APPLIES FOR PERMISSION TO C�� �T2-A%CT 1`i1�M1 l ��vlv i�10L`S� j��L� <br />i� :� C� L f�� . <br />� Z / G — . _. <br />AT THc FOLLOWING LOCi.TION �� � 1'���� �� �r c'rccr%��b-- <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 259-887 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />OAaiNAGE <br />SiHEET <br />DEPARTMENT APPROVALS <br />ClR1AlUNICFiiONS <br />PIANNING <br />FPPRPVEOFOR CONSTRUCTION �AiE <br />nPFHOVEOASCONSTFUCTED �'�'�E <br />� U i:T �. ; . ._; � <br />DRIVEWAY SECTION <br />� j I., LIP <br />1�30 � f 3—'1 <br />T�e untlersignetl owner nereEy agrees to hold antl savo �armless <br />I�e City ol Everett Irom any end all claims br �amages. cusls. <br />eaFenses. or eauses ol atlion B�at may nn5e because ol installnbon <br />a��A maintewnce o� �nc �mprovement w olher ngn�-ol-way use <br />hcrclo aPPlm� Ior an0 Iwlhcr aqrc�s lo rpmovc same opon noticc <br />I,om Ihe CiIY lnU �o �epla[e V��L'dc pmperly tldmOgnil V�croOv <br />C�-�, - <br />; �- <br />�- �J .i= �____ _ _ <br />SiGNF1URE OF APPLiCPNi <br />1 �i' � O �� � 5"'i M ��� �'i I� � _ . <br />•OOnEss <br />l�1MZusvi�.�� �.iA qf;2?o <br />IlV ZIP <br />5� •3C� c7 - l! I I - <br />TElEPNO NtIA�pER ALIENNAIE <br />/ �� � U l, <br />pAtC <br />� <br />� <br />