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!Y!f!n <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />� Type or pnnl cleaily wlth mk <br />�� PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS PERMIT N0.1��� <br />EVERETT,WASHINGfON <br />APPIICANT (UNDERSIGNED) AND FIFM REPRESENTED, IF <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION <br />n <br />%P.M�NG/fA�t .C,tu�l�ck5 <br />__ _ _._3 �11—a� `-" <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTlON 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPFOVALS <br />a� N 1 jaJ.7 r� <br />DRAiNAGE <br />,,.lf1JY] �O � I IJ <br />WAIER �2�li:�i:��:fi <br />S1RE[T <br />COMMUNiCAilONS <br />ia <br />PLANNING <br />A R E�ON�R 7��� ��� �� <br />,�,� _... _ .. .. <br />ORIVEWAY SECTION <br />{I" LIP � <br />i <br />�30� -- <br />30" <br />Thc unCersignod or.ner �ereby agrces Io holtl antl save harmless <br />1ne Clty o� Everett imm nny and all claims lor tlamages. cosls. <br />ee0ensei oi causes of aclion that may anse �ecause o� inslallabon <br />antl maintenance of Ne improvement o� other ng�4ol-way use <br />I�CfCIO BOPLEA IOf dnd IW�M1cr 8 jlCes �O fCmOVP SOmC upOn nOliCe <br />liom ine Gity an0 �o �epiace pubi�c �ropeiiy 4ama9e0 inereby_ <br />l�' �r/��� r /' � <br />� q//�� i � a��>r_,c,,", i�<,t_ ,. <br />S��G N/T�U�p[O� PVV�ICPNI <br />1117/3 .5'1//A/�✓/tul lF. �.L� <br />A��aESs <br />�M .�1 [uUu-^� 1JJ :t �Y.�'.�l ` ;�_ <br />cirr Ziv <br />_cn i �) — %L �� / i:...� � — ���? � � <br />iELEP110NE NUMpEF ` lLL1CI1NAtE <br />i�._/ ,z ; / � ' �'% %� - <br />,.,, � <br />