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r ��yy <br />everetl - <br />Q APPLICATION FOR RIGHT-OF-•WAY USE PERMIT <br />� Type ur print clearly with mk <br />�� PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO. ��� <br />APPLICANT (UNDEflSIGNED) AND FIRM REPRESENTED, 1% ANY: <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION ZS�z k�� C�uf S� Eve�e�+ l"�r /�ZO� <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY UF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CAf�L FOR INSPECTION 259-BB 1 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWEN <br />ORPINAGE <br />WRLEN <br />STPEEi <br />DEPARTMENT APPROVALS <br />COMMUNICA*iONS <br />TqpiHC <br />PLANNING <br />%' y <br />APPR/'V�ED fQ}� CON TRUGT�04���/. <br />/ l� / .'%� `�O!1 i''i't i � � � / /� / <br />DRIVEWAY SECTION <br />� I'� LIP <br />i <br />�30 � �30�� <br />The unaersigneE owner hereby agrees lo hold anA save hermless <br />IPe City ol Eve' ��tt Irom any an0 all clalm> �or Oameges, costs. <br />eepenses. or causes ol aclion Ihat may arise because ot mstallation <br />and mamtenaoce ol Ihe improvement or ot�er rigM-ol-way use <br />nereto av���ea Ior an� Iwlher agrees to remove same u0on notice <br />irem Ihe Cily antl to re0�ace puChc pw0erly aamaged Ihere�y. <br />��% i�[�'Q�(/�'�1�'/ 1/�' —, � <br />SIGNPiUAE Of PPPL�LANi <br />G>"ox a ��� S�v <br />PDDAE55 <br />islou n T�A//c TCr'Y.i c c q� �y3 <br />OTv �7 ��P <br />% %l/— � %JS <br />1 El f���PNC NIIM[iER AL 1 E�NRIE <br />3/� 7/A/ <br />