Laserfiche WebLink
..,_ <br />everetl <br />� APPLICATIDN FOR RIGIiT-OF-WAY' USE PERMIT <br />Type or print cleady wilh mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON �^, , � PERMIT NO. �� �d O <br />APPLICANT (UNDERSI(iNED) AND FIRM REPRESENTED, IF ANY: 1`� i1 � Il� /� S��� �'L. _ <br />HEREBY APPLIES FOR PERMISSION TO� ��� U� I(�I J � �} C IL� � C P1 �� I I�� p�� S I� �� G� <br />o� U � ��-1� � �z�� ' � /l!/ <br />V�+. <br />AT TI1E F01 �pyylNG LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR �SO DAV,S <br />COPY OF THIS APPLICATION TO BE F75TED <br />ON JOBSITE. <br />CALL FOR INSt�ECT10N 259-881 1 <br />24 HOURS BEFORE CONSTNUCTION <br />DEPARTMENT P�PPROVALS <br />� _.� -,'�1� Y�.� <br />,c. ; ...:.,. .:r.� <br />GON51 HUGT ION/AS flUILT <br />v� <br />�OWe <br />DRIVE`NAY SECTION <br />i <br />� � <br />�- j I" LIP / <br />�30" I_30"� <br />T�e unEersigneE owner hereby agrees to hole anE se��e harmless <br />Ihe Ciry ol Evcrett bom eny and all claims lor dameges, msts, <br />e.penses, or ,�uses ol action Ihat may arrse becaus� nl mstallation <br />and mamlenance ol Ihe �mprovemcn� o� oi�ei ng��-ol-way use <br />her�lo appLetl br ana lurl�er agrees lo removc same u�on no��re <br />Iwm I�e Cny antl to replace publm prpperty aTmaged Inereby. <br />� <br />� (��� if <br />�1( l�n��/ I��dKa� �-�1 �cL,�.�� �� <br />'d�GNniunE OF nPr��CANi � <br />��03- 1�7 SE <br />noor+ess — �--� <br />�� h� I I, �,,�r�sti qs�o„ <br />��.�Z��. <br />- �6os �i��-��sa <br />tEIEPHUNE NUM�ER qL1ERNPTE <br />cTUfle l4. I� %� — <br />pRIE <br />