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,- -„ <br />everett <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Typc pr pnnt clearly wilh mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT.WASHING70N <br />'i APPLICANT (UNOERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />i HEREBV APPLIES FOR PERMISSION TO <br />PERMIT NO. _ ' �F✓� <br />�i AT THE FOLLOWING LOCATION �— ~ < <! r - , � ' � <br />.�—__ .__-- —_ <br />' DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />I � ���� ' n �t U.c^�L�L�.�'7"%2S7 <br />� -�iz� ,ri�i��0 ��Gx-dSZ, �=�'�55 S - 7g <br />I <br />i ���, z� �/� <br />� <br />�J <br />� 1I / <br />/� V <br />J �_ is� <br />7�� <br />PERMIT IS VALID 1=0R 60 I�AYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-B8 7 7 <br />24 HOURS BEFORE CONSTRUGTION <br />DEPARTMENT APPROVALS <br />I <ewta <br />I nnair�qne - <br />I WAiER <br />STREET <br />Cor,.r.�upicnncr�s —_�. <br />innrcic — <br />P�ANNIVG <br />. APPROVEDFORCONSIqUCTION D�iE <br />I <br />qI�PNUA'LI: �ls COIJtiIH'JG�EII OniE <br />v,,,a pi�ov�c� .C//�d <br />DRIVEWAY SECTION <br />f'--- --- -"! <br />�7I <br />�� +I'� LIP � I <br />L30" 1 _ _�_30" I <br />i - � � '�1 <br />The unOms�gneG owner hereby agrees lo �old entl save �armless <br />Ihe C�ly u� Everelt hom any antl all claims lor damages. cosis. <br />r.penses. or causes ol ecbon ihat may ause because ol mstaliation <br />an� mainlenance ol Ihe impip�emenl or oiher ng�4oi-way usc <br />neretu apphed loi and lurt��er agrees �o r�move same opon nouce <br />��om �he Gty en0 lo replxce pubLc pmperly 4amago0 ihere�y. <br />���� %TL+-itint "r, � ��L; I�r ���%'ii3G � <br />iIGSAIUAE O�/PVPUG4N1 <br />�� <br />4%L�.. I,r�h /,r.�7.� � i. <br />PpU�lE55 M I <br />_�__�: f_.. :ri %�i' � � �� I !. l � � <br />U1v � ZIP <br />� ` � I 1 � <br />TELE�'rOYE NUMpER qLTERNPiE <br />nal t' � <br />:ii _--_ . __ __ ._. _ _— __ _._. . _—.— i9i9 I <br />