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i <br />� everetl <br />Q APPLICATION FOR RIGHT-OF-WAY USE PE�iMIT <br />`' Type or pnn� clearly with ink <br />' PRESS HARD - 1'OU ARE MAKING COFIES <br />, PUBLIC WORKS / <br />�I EVERETT, WASHINGTON PERMIT NO. � U U <br />�i APPLICANT (UNDERSIGNE�) AND FIRM REPFESENTED, IF ANY: �/!. /"I /IU vl v'� 1!J� L� ___ <br />HEREBV APPLIES FOR PERMISSION <br />�(i���L. 1' 1�(tT'< <br />AT THE FOLLOWING LOCATION <br />� ..�;�i'� � ( ✓ 'U' �_Y1 <br />(,(.iGvpj l.v�. � �il t � d/' <br />—� �i .11 <br />v <br />0 <br />�, , ,_,, t.l� . rrc�Nl� l� j <br />� �f�� H�V�' . I <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />l - � �.0 �Ci �� ���riGtr` <br />I 4iiS i�R.(�u��' �S iSS�i.c 5���(Cc� <br />J ,. <br />v: �(} 7� C,Sl. l U-� <br />� CJuC� I��Cti��� SS S " <br />� l Lw„ e..� (, l <br />/ �-.^�}i' , <br />� � t� c�5 �-o ��� G� ��t�� � �d l-�. , <br />� 1 <br />I ' � -�� ��-� -� c�''��Z �r F� I�'U;�(( <br />�� �, �� �t U, I/� � N I <br />� +, Je. bto� �(,tVl �Ypt]1�:��V -(�J<.� C il��u� �L� <br />� �J <br />`� .l. � f�< f�<v �55��� �� �-���� c.�� IC Ouc��,�— <br />!.� ��J � i� o.,.,_� �ti�-l•� `J, I cv� �-Ct <br />pr����.e C��S����7����,� u� <br />—��u . , <br />�� �x 1✓�� . �] � <br />�i � � ' -��-CJ � U 1 �C� !G1 c <br />'jJ�(¢.c� '�(�'E � IM C' �� S � � <br />v <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 BEFOR[ CONSTRUCTION <br />DEPARTMENT APPROVALS <br />51:N[H Co6uNNiCntioNS <br />1 <br />OiA1N�GE TRAFf IC <br />/ <br />KATER pLAN ING <br />SfRE <br />i <br />� � - . � C�� ��.��.-� <br />AP OVE� FOF CONSTRUCTION "0 tE <br />� C�.�.,t__� / rlr'iz�� � � <br />PVVR A$ CONS UC1[0 DnTE <br />� <br />CONSTRUCTION/AS BUILT <br />DRIVEWAY SECTION <br />�— � <br />�I" LIP <br />L 30" �_30" <br />r <br />The undersigneE owner hereby aB�ees to �010 enU save �armless <br />Ihe Ciiy ol Evereli Irom any anE all claims lor Jamages. cosls, <br />e.penses. or tauses ol acliun IM1aI may anse because ol installalion <br />and mmntennnce ol Ihe impmvemenl or olher rig�l-obway use <br />heicto apVLeE Im antl lurl�cr agrees IG remove same uPon nol¢e <br />Irom Ihe Ciry and Io replace Oubl�� pwpeny aamagetl IheieCy. <br />� /��/L'� /�" �u/ /l �j � <br />. �/ iUP� f qPPIIC�� �� �. <br />E h' /. <br />ADDRESS <br />; t�,,., .-�r Gv.,</, '/�G'�O <br />�CIIY IIP <br />7 7�= G 6c�� �S� 5,��/ <br />1ElEPMONE NUMfiER A�IERNFiE <br />� 4- <br />o�1e <br />J✓ `� <br />vEE 1B%B <br />� <br />