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APPLICATION FOR RIGHT-OF-WAY I <br />Type or print clearly with ink <br />� PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVEHETT,WASNINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />PER <br />HEREBV APPLIES FOR PERMISSION TO�_NS �NLL ���Z�v�W���----��-- <br />PERMIT NO. ��/ - �`l <br />AT THE FOLLOWING LOCATION_ <br />�� i0 2/ £r ff E�e.r�1Y�% t 9BZ0/ <br />pppWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />�IiJ' �Ii�2.l,liJO<iS &IiJ.�f✓�'la�— /"�/'.��TTiN/— � ��Lr-' <br />-i�. /2:�.:1�i1?O//�Ci'��r:i> ITi ��r'.�C�C /��a�s <br />V <br />Si%T/S�-iK•%On/. �. <br />PERMIT IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-6B 1 1 <br />24 FIOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />-�'_ <br />59VER <br />ORR'nAGE <br />"� 5 r,7 <br />WATER �f � <br />COMMUNICATIONS <br />iR4RIC <br />� ; _, � ' , <br />�I ��.n INMG <br />�, � — <br />STAEE, luQ� i ,' 1 -- <br />ti � <br />A �.._/ ♦n7. �_�� <br />APPROVEDF CONSTRUCTION �A�E <br />" �n -S - � � <br />��PP OVEO AS CONSTR C7ED <br />pAiE <br />CONSTRUCTION/AS CiUILT <br />/�1�.��-;,i �� �r�t.s� <br />i/� S i��lt ;'L+i' s <br />ORIVEWAY SECTION <br />' � I" LIP � <br />�30„ _�_30 J <br />The undersignetl owner hareby agrees 10 �olA anE seve harmless <br />Ihe City ol Evmell Irom eny anE slt clnims lor dameges, cosls. <br />e.prnses. or causes ot action �hat mey nrise because ot inslallxtion <br />t�ereto appbednbr nnd Wrl�e�rrag Ces IooemovB same upcn�noi ce <br />!rom �M1e Ci�y and to reVlace pu�lm prOVetly tlam2ge0 �bereby. <br />�- � ��_, `'] <br />� � rt � � <br />SIGN�IUFE OF /.PPUCANI <br />U��..7 �iiSL �'�IUU1 ST <br />AD�AE55 <br />��i� 2�� ��� 7-"�-+, <br />CIiY t < ' � ���� <br />�� J C / � � /AVEPNATL <br />1ElEPHONC��UM 1[� <br />UAT� � U /- . _ <br />1978 <br />