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r <br />• • � <br />evcren <br />� � APPLICATION FOR RIGHT-OF-WAY USE PERMIT , <br />Type or prin� cleerly with ink <br />PRESS HARD - YOU ARE MAKING COPIE."i <br />PUBLIC N'ORKS pERMIT NO. ��/lc...�— <br />EVERETT, WASHINGTON � <br />.�/p� � 4cN GoNs i�� nwR(-Kc l-I NAL/1 ACN ) <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY.�.— <br />HEREBY APPLIES FOR PERMISSION TO V S� A<< E�' I_ U/3 /�C C CSi 7n P�R/f I/�L --- <br />AT THE FOLLOWING LOCATION J 2 4 t,.iA�nivr �f �l�Q�/'L' tT/ ��[%a' 7���� <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERM!IT IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWEIi <br />pRAINAGE <br />WATEfl <br />STAEET <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />TR4ffIC <br />P�RNNING <br />//—f- /l �-�— �l�Zo�g/ <br />nPPROVED F R CONSiR CTION <br />— �AIE <br />�� �J � � ��. �'�.' ��� <br />DRIVEWAr SECTION <br />1 +I�� LIP � <br />� <br />1�30" � � 30 � <br />The undersigned owner hereDy egrees �o holC anC save �ermless <br />t�e City o� Evere�i Irom eny end all cla�ms for Oemages. cosls. <br />evpenses. or causes oi action ��at mxy anse �ecause ol mstallation <br />and maiNenance of IM1e imOroveme�l or ol�er n�hl-ol-way use <br />hereio apphed lor ana �w�ne� agrees m remove same uDon not¢e <br />Iwm Ihe City and lo re0�a�e pub�ic pmpe�iy Camaqe0 InereEy <br />,�.� ��' -f <br />SIGNATURE OF FPPLICANL <br />Li 3L NiG�a�q,✓a <br />nooncss <br />F�E�t�rr G,,Asir q82o� <br />C�iv <br />252—�v5° <br />AUERNPIC <br />TELEPMONE N W��ER <br />4-g-81 _ -- <br />