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APPLICATION FOR RIGHT-OF-WAY USE PERMIz <br />U Type or print clearly with mh <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS �<" <br />EVERETT, WASHINGTON PERMIT NO. "� - <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF <br />IIEREBV APPLIES FOR PERMISSION <br />A� THE FOLLOWING LOCATION <br />L i� � � N/� 1,�: .. � i r <br />DRAWING (WORK TO BE nONE) OR THREE PLANS ATTACHE/D�: / p _ �` <br />�l[P''�0,� _-\�iaCf�'10\"YoQy�rP.�to✓�" .IOr <br />_�_��1� }� // (I I Y�Pw CJr L, �v �/...0 6I,� � o., U✓.I.,uf <br />i Ci vf'- <br />� . �/ ! r_i ., lloa � �,,,�,.�,�...-t <br />� <br />� ll)��-.p�o.o...� ao �(�:r <br />/=i3'L r�l�� � Cl,,lY/ � �_�-� � <br />�` <br />C��'n"s.��l. i�,/�/B <br />�RO v � 1� p h o�c p-.t r/%�C- U�,Oi ,a-..� P <br />�+..s'�.// c �.6.Fyo/l0 � u..� a� s. o�%t...o%E- � 7 Nov✓h sio% rz6 �r�`J <br />��,., cv� ,(.. �Pr�.Ic e ��.-S � Sro�� �..o�k �� �/.V.�� �" � �-�, .i T G/ <br />w�'er� � ' <br />� �'e.R R� �/�'s �t I' ,PA�I � � . <br />j�,�.e A�l�� �=r�o�, i��-sr; �-o so.�,r� ��eeP• z.�c . <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION' 259-981 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWEA � <br />DPAINAGE <br />WRTER <br />STREET <br />COMAIUNICRTiONS <br />iRpfFIC <br />PLANNING <br />APPROVEDFOF CONSTRUCTION DntE <br />APPROVEDASCONSTRUCTED �aiE , <br />INITI�L INSPGCTION REQUESTED <br />DRIVEWAY SECTION <br />� � j I'� LIP l <br />�o�:} .4 ao�� � <br />Tho un0erslgne4 owner hereby agrees 10 holtl and peve harmless <br />the City ol Everett Imm any antl all cleims lar Eemages, cosls. <br />expenses, or wuses ol action ihai mey anse Eetause ol inslalletion <br />and meinlenance oi Ihe �mprovement o� oNer ngpl-obway use <br />nerelo anpLed lo� and luriher agrees to remove same upon nol¢e <br />hom Ihe City dnd Io reDlacc O��bl¢ property tlBmageC thereDy. <br />S iL�GK1�/� <br />i � , <br />��.} J; i <br />f�"Gf_r, yn � � �`� � �'� _ <br />'�SIQN/ IURE OF APPLICANT � <br />G 3 L,.,�G �,t � ;�� <br />nooness <br />Sa�6��2�sJ ,..�, . / k�a %o <br />�ir� � z�� <br />��l �— � .� <br />iBCPMONE NUMBER' �� � � � Al1ERNRiE <br />��— 3 0 - 7r�' <br />nnit <br />