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Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />V _ <br />Type or pant 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./&dry- C./'•���(�'A� <br />HEREBY APPLIES FOR PERMISSION TO G•�+ yo7 �1EY^ ' ^^« EV/^f Cdir <br />� % lots 1c..2 cf 8 sae e ; av S .xt ^ . .'eti tiM�/r <br />AT THE FOLLOWING LOCATION 3601 0, �m of f I#V e. r x lrj,X f,d 34 <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: AM <br />SK��4. 4&D <br />car?*.l� <br />s <br />il <br />`1 <br />V <br />SEE a1T c�E� <br />AMEW e4r. <br />4,, <br />r <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DFPARTMENT APPROVALS <br />3'haa lj�a, A 4t o�n <br />d�� Srel�S 0f 'fk-TL'ril_/yq <br />DRIVEWAY SECTION <br />I" LIP_ <br />30" 30" <br />The undersigned owner hereby agrees. to hold and save harmleas <br />the City of Everett from any and all claims for damages, coots. <br />expenses, or causes of action that mat arise because of installation <br />and maintenance of the improvemert or other right-of-way use <br />l ierelo applied for and further agrees to remove same upon notice <br />from the City and to replace public properly damaged thereby. <br />Wpcve <br />1 f �7 L Uert �%>S � J �o <br />�'t• 7 �j (�tyin (/ <br />qpp R CONSi U 'T O - Ox' -O / / _ V(� Y 7 S D <br />TELEPM NE NUMB ALTERNATE <br />1, '4 it//Is /979 <br />APPROVED q5 CONSTRUCTED OxTE <br />4- <br />REFERENCE COPY FEE <br />1978 <br />