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everltNl <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHINGTON PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR ,,PyyERMISSIONIF <br />AT THE FOLLOWINP LOCATION_ <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />A)Pw 0VA r•rr.r( iq d/'�a �..-.�I <br />1. Id.,44ii- �kv-,-6 �d �Tr:StaF!•'-.i rely i0 /]D. i1v r.♦i">✓i Lr.ol�i <br />Pa4/ 4atf•✓t ) Jlxr (oi.i,,„I ' Ct�t-11 <br />S. AIlii'1U )F oY 41T^ Iyr r�O <br />' � Tvr� �, /opks {cc <br />���ae� idYnP,w <br />r O tr�t 1tc L gpynv <br />SI.JPIrf LP I* <br />�Ir 01VA. Ii.T�'r S'9-$0 <br />S'� DfdIN eraPP a Cy/p' _ <br />I CI 0 S <br />Z\4 Q 9 id;w4;� <br />�Tr\. <br />ae PV'O'Fl -Srees, <br />11 nl+.= j <br />0p -e o,•. (Jla t'T s-VLaL,T rx.11 slci ewc..l lam- co,.♦L. rewvJL.J0 3 <br />G-9re(� o <br />COE :aQw —Cw� v♦rarFa� Score r <br />eI <br />�11 bry or uws.. ntS�'t�1 cn rla r sidewtlk Li �� la rsef a W. ett` <br />0.^ J Or <br />U��f♦� lS �e \�'o rOJeey �� CA lnc r_ 5 Ow <br />a1�1�``tic�� wor� o..� PLaLr�s. <br />new,` <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-691 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWER COMMUNICATIONS <br />DRAINAGE <br />STREET <br />TRAFFIC — <br />APPROVED FOR CONSTRUCTION DATE <br />APPROVED AS CONSTRUCTED DATE <br />INITIAL INSPECTION REQUESTED <br />DRIVEWAY SECTION <br />Iii LIP <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 />expanses, or causes of action that may arise because of installation <br />and maintenance of the Improvement or other nght-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 />AooRa�s <br />CITY <br />TELEPHONE NUMBER , ALTERNATE <br />i <br />DATE <br />