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everetl <br />� APPLICATlON FOR RIGHT-OF-WAY USE PERMIT <br />Type or print cleaqy with mk <br />PRESS 1iARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHING'fON <br />APPLI�ANT (UNDERSIGNED) AND FIRM REPRESENTED. IF� ANV: ���LM� <br />HEREBY APPLIES FO�R(1 <br />%i" G/J-/i= /i <br />- � L' G.;C'/-Lf'� <br />AT THE FOLLOWING LOCATION ��� ��G' u/vC/✓;.�' <br />�lr�' � <br />PERMIT NO._$/fZ6T _ <br />��� / <br />lP�. ,/r!', <br />�r/P i'� jJ� <br />DRAWING (WORK TO BE DONF) OR THREE PLANS ATTACHED: � <br />� � � �. <br />�Iy <� �_�.s � <br />��� / _�� ✓e l�i �- ,/ <br />7 I 1 G7,,'�.:: �_�u ,� c1 �' � ���. � <br />i�' _ .. _ ._ <br />/' _ _ _ <br />i \ - 7�' / ___ - _�r._ .. <br />I�E%CI (✓(�l�.s� / <br />I � • �%-{1.� � + -�-i,L�t,4 - � C.�. ' %�vLl��l�(�fyLL(iX� <br />J <br />� � / <br />I ,� � �� <br />3 _��.� � � � Q G,���.� <br />, <br />; -�-�.-e, � <br />-2 ' �o-ja� ' J..e�u-P—rat�>-c.� % , ''�Ou(', <br />�� <br />! � � �� e._ �cP <br />�����, <br />�� ,. <br />PERMIT IS VALID FG�R 60 DAVS <br />COPY OF THIS APPLICATION TO BE P05TED <br />ON .iOBSITE. <br />CALL FOR INSPECTION 259-861 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />� <br />sEwen .� ; � •�C`OpIMUNIUTiONS <br />C;.. 11� � �' 1 <br />PRPINAGE . � • 1 � �'1RAi{IC <br />C^`'�.�% • <br />WA1ER I'\'�` �� , . PIANNj01G <br />;� <br />. .�` <br />STREEY V` �' �j ��% <br />��,. . n . <br />; �� � � ; � / � _�o .ap., � 7 ��3�/ <br />�_ <br />t <br />�> <br />�� �L�r�� <br />-�L���' <br />DRIVEWAY SEC710N <br />� ��� LIP <br />L.30'_�_ � I 30.� <br />i -..� <br />The unGervqned owner �errby eprees in hold enC save harmless <br />Ihe City o/ Eveieti irom eny and ail �laims lor tlamages. costs. <br />evpenses. or �auses ol aClion thB� may qnse because ol inslalletron <br />s�tl mam�enan%e ol t�e �mprovemml or othei nght.ol�wny use <br />hereto apP�•'4 lor and Ivri�er agrees to remove same upon not�ce <br />Irpm Ihe Cr�y an� Io replace pobL; p�operly aamaged t�ereby. <br />%o )...,� � �( � <br />SIGN4IUFE OF /a4`P�ICqNI/�// / <br />/ T��Ei'C- ('� l.� �i'.�/ <br />now+Ess <br />��.—. <br />L���^ ���li//�:S f� ���-Oj <br />�>2S 1 3 ziP <br />e ��,� <br />1ELEt�HONE NUMf1[F M iEFNA*t <br />J� �o '� � 4,�� <br />��,� - <br />