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<br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT
<br />Type or prinl clearly with ink
<br />PRESS HARD - YOU ARE MAKING COPIES
<br />PUBLIC WORKS
<br />EVERETT.WASHINGTON
<br />APPLICANi (UNDERSIGNE�) AND fIRM REPRESENTED, IF ANY:
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<br />HEREBY APPLIES FOR PERMISSION TO � u� ��� �"` �I
<br />r�J'o • $'34,L
<br />PERMIT NO. 3 7
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<br />AT THE FOLLOV'ING LOCATION _ SozS� - ��. �mi Jq �"an �Evere7Y" / /o /820J
<br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED:
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<br />PERMIT IS VALID FOR 60 DAYS
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<br />DRivtwt�T ac�, i �.,..
<br />COPY OF THIS APPLICATION TO BE POSTED
<br />ON JOBSITE.
<br />CALL FOR INSPECTION 259-881 1
<br />24 HOURS BEFORE CONSTRUCTION
<br />DEPARTMENT APPROVALS
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<br />COMMUNIC4LION5 ll �," 1�'i
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<br />ONAIYAGE i�nFc�C �
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<br />WATEIi PLANNING
<br />STREET . 3�i1,' :' .:
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<br />APPROVED JOR CONSTRUCTION� -� qtE
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<br />� jl" LIP
<br />L 30" 30"
<br />T�e untlerslgnetl owner hore�y agrees to holtl antl snve harmless
<br />the City ol EverMl /mm any ena oll Unims lor Eamages, cosls.
<br />e�penses. or wuses ol aclion ihat may nrlse because ol inslallnlwn
<br />antl mmnlentnce ol �he improvement or o1M1er nghbol-way u5e
<br />hereio dpphep lor and Iuriher agmes lo iemove same upon noLce
<br />hom the Ci1y anG lo replace OuEbc propei�y Uninaged IM1eiEOy,
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<br />SIGNATy" .Of APV�ICANI � �j yv`/�
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