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�\ <br /> i everen � <br /> ' � APPLICATION FOR RIiaH7-OF-WAY USE PERMIT <br /> iType or p�^it clearly w,�h ink <br /> , PRESS HARD - Yi.IU ARE MAICING COFIES <br /> PUBLIC WORKS <br /> iEVERETT,WASHINGTON PERMIT NO._'� <br /> APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IP ANY:n�L�__� �"` -I . � � - ��.: r " /'. J i�_ ���.c ,� � <br /> I � <br /> ' HEREBY APPUES FOR PERMISSION TO � -� � �-� - \ � �-I�5 f�/-�r� /� % f�/.i�_ <br /> i \ _ <br /> I 1! i/- 1 <br /> �` _. . _. ;;:,� .. � . <br /> � � � � <br /> AT THE FOLLOWING LOCATION � /�:' �� _� i`��r �: l:'f I'J�= ��"- � n <br /> i DRAWING (WORK TO BE DONE) OR THREE Pi.ANS ATTACHED: <br /> ' ��� Rv �,c1 �- ��b 7 <br /> i - <br /> � <br /> � _ . <br /> � <br /> i <br /> I � <br /> i <br /> � <br /> � <br /> ; <br /> � <br /> � <br /> � <br /> � <br /> � <br /> ; <br /> DRWEWAY SECTION <br /> I <br /> PERMIT IS Yet1LID FOR 60 DAYS � � I <br /> i COPY OF THfS APPLICATION TO BE POSTED + i" uP <br /> � ON JOBSITE. <br /> � CALL FOR INSPECTIQN 259-881 7 �'30" � �30" i <br /> ! 24 HOURS BEFORE CONSTRUCTION <br /> 'i The untlersigne0 owner �ereDy agrees to hold antl snvo har.nless <br /> ! �nr Gty ol EvMett Imm any an0 all cle�ms lor aamages. costs. <br /> I ��.prnses.or ceuses ot aclion Inat may nnse�ecause ol installehon <br /> � anil mainlenance ol �he �mOrocrmenl or o�her right�ol-way use � <br /> � n^ie�o oppM1M lor anJ lurt�or ugreos lo remove samc upon nol�ar <br /> i hom tM1c CiIY .�^� lo rrplJcc t���bLc p�oOCtly 00mnuca Rnnebv � <br /> I DEPARTMENT APPROVALS � <br /> scwcn coun�urvicanons --- <br /> � <br /> I pRA�N�GE tRRfi�C _ � . �.. _. � <br /> � � ' I I � I -" 1 \i � _ - . h . <br /> I WPiER ' PL4NNING . S�GNRTURE Of RPPLIUM � <br /> , <br /> � .� l. I >l � � <br /> �� — -„�� <br /> SiREET ' AODPE55 <br /> I �� 1 . . � )_- I .. � / � i <br /> crtr , nn i <br /> i APPROVED FOR CONSTFUCTION on*E ' �. , , ; _ � - I <br /> I � LELEFHONE N�M1i�EA AiIEPNA�[ � <br /> � 'I <br /> APPROVED AS CONSTPUCTED oniE Dat[ °� � <br /> I <br /> p I <br /> ���(ll <br />