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"� APPLICATION FOR�RIGHT-O -WAY USE PERMIT <br />Type Or print Clearly with ink <br />�r Mi <br />PRESS HARD - YOU ARE MAKING COPIES G <br />PUBLIC WORKS PERMIT N . % (�27 <br />EVERETT, WASHINGTON <br />TIL <br />APPLICANT (UNDERSIGNED) AND FIRM qE; I�€ST,EQ.yF AN �CJ ��� �tSl It ( C <br />HEREBY APPLIES FOR PERMISSION TO C rC I/—/l , <br />AT THE FOLLOWING LOCATION /-� `l� c 1 <br /><iL'r 0e <br />�eT�rorzc= <br />�- <br />C) F (X)/j U, <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED, <br />Thy � I?p rLVlt� 1 � I<.:.SVPLI �Vfr` c^ <br />1 p �GLGLt9(� I['1 C �i <br />�acP <br />�IS Q�SV S✓�)�Pf.� i� ✓e J{I C.:-�t(1'p�o <br />�r flA t� I <br />?S d ` G�Cvr�d ' f r � <br />-tp' I I if AV f. Sj <br />' .: to <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-681 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />COMMUNI 1IT IONS <br />TRAFFIC <br />PLANNING <br />DRIVEWAY SECTION <br />— —� <br />LIP <br />t— I <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs. <br />expenses, or causes of action that may Anse because of installation <br />and maintenance of the improvement or other rlghl-of-way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged thereby. <br />SICNAIUnE OF A°PLICANI <br />�I <br />CITY ZJ. <br />]4 2 -t . <br />TELEPHONE NUMBER AIi ERNAiE <br />DALE <br />APFROVEY AS CONSTRUCTED <br />