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� �� M1 <br />���i�\� <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type Or priN tlearly with mk <br />PRESS HP.RD - YOU ARE MAKING COPIES <br />PUBLIC WORKS �' <br />EVERETT, WASHINGTON PERMIT NO._�U � <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF AtJY. <br />HEREBY APPLIES FOR PERMISSION 7(` <br />AT THE FOIIOWING LOCATION � � / � /��� �' f �'--'�� <br />DRAWINC (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSP�ECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />OFRIN/GC <br />WqIER <br />DEPARTMENT APPROVALS <br />f,OMMUNIGAl10N5 <br />TRAfFlC <br />PLRHNiNG <br />�� �' — n u <br />� ,i� .t. . _. � �_ - <br />PPflOVED FOF C STRUCTION OntE <br />APPROVEDAS GONSTFUCTEO UAiE <br />ORIVEWAY SECTION <br />� �I" LIP <br />i' 3� � 3 � �1 <br />Tne untlersigneE owner hereby agrees lo holtl an0 seve hermless <br />Ihe City ot Everett Irom ony and all claims lor damages. cos�s. <br />rvpenses. or causes ol acbon I�al may anse because of installal�on <br />and mamlenance ol Ihe improvemeni or olher ngM-ol�way use <br />hmelo ap0lied for an� lurihe� agrees lo remove same upon nol¢e <br />!�om Ihe City antl lo replace pv�hc pwPe�ty aamxgeE Inereby. <br />�yw�.�r/' � <br />( UV �U� � W"i <br />�µ � _ <br />SIPNqTURE Of RPPUUNI <br />.. �v;"� Z �Q�' �i - <br />noon[ss <br />`��,, i� ���.,i; : ,� . '� l 40 <br />��,. � �,�. <br />��Y- ,�71 <br />TEIEi'NON[ NUMpER ALIEN�FIE <br />l- 7-�U <br />DPIf <br />RE�ERENCECOPY �Er �978 <br />- -. �""'�-..�'F,_._._ . -. _ , � �- -�� . . . . . . .. . .. . . � - . .r;�.� _ - , ,. , <br />