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, - . , <br /> 4 <br /> i j I <br /> 4 <br /> li i <br /> , ��e � <br /> � APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or prin�cl�a .y with ink <br /> ' PRESS HAFD - YOU ARE MA�CING COPIES I <br /> PUBLIC WORI:S � ��/� <br /> I EVERETT,WASHINGTON PERMIT NO. <br /> IAPPLICANT(UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: � �' �� ° ^�� " <br /> I <br /> i ' 1 ,�n�'ve Wo J <br /> I HEREBY APPLIES FOR PERMISSION TO ��S�' f K'S T�7`l4 G 6.JC�-CTP � <br /> � <br /> AT T '.E FOLLOWING LOCATION �3J�fit �C � �� <<!/�h�/ T �✓�• 9dz�3 <br /> —� 7 <br /> i � �(� 7—/.�—.YC <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> I <br /> .� <br /> � <br /> II <br /> I <br /> I <br /> DRIVEK'^" �FCT�O�J I <br /> PERNlIT IS VALID FOR 60 DAYS I� --.� <br /> I <br /> COPY AF THIS APPLICATION TO BE PUSTED i" ��p � <br /> ON JOBSITE. �30" _�_30" <br /> CALL FOR INSPECTION 259-861 1 <br /> 24 HOURS BEFORE CONSTRUCTION The undersipned own�n c�reby agrees to holtl and seve ha�mless <br /> Ine City of Everell imm any ana all daims lor �e�nayes, rosts. <br /> e•Oenses.or causes ol acbon that may anse because ol installalion <br /> ann maimenance of Ine imnrovement or other ngni-o�-way use <br /> ne�eio avni�ea m�and furi�er agrees Io remove same u0o�no��ce <br /> Irom �he City an0 to replBCf pvbl¢ Omperly aamaged ��eieby. <br /> DEPARTMENT APPROVALS <br /> ytµ�p GOMMUNICAli0N5 <br /> DRAINRGE �AA«�� <br /> [ <br /> il �• fi� <br /> WATEN VUNNING SiG UFL OF PPVLiC<Ni � <br /> 8j�� �OOf.t Re� Kd. <br /> STREET AODI1E55 �`y <br /> I r �(f�Q� 1 � IV lU3 <br /> �r� �07— ��i�/�'o �,,. �`�' ��� <br /> APPFOVEU FO(j�ONSTRUCTION /•TE �J S " �oP I Z <br /> iElEP11UNL NUMOEP AL1EfINR1E <br /> 'a?'/7�Pj' �7�f J,d'o <br /> fiOVEO AS CONSTRUCTFO DArE Un*E <br /> iCONSTRUCTIO�V/AS dUILT ,�E �978 ' <br /> .- <br />