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. <br />� :. <br />-- erercn . <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMiT <br />� Type or print clearly with mk <br />_� PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS PERMIT NO. t-'�-1 �� <br />EVERETT, WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF AiJY: <br />NEFEBV APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION S'9Z O X O v� F r I/��6 �/ <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: ��— ���_� <br />� <br />1 Je'`/' �% _.---I ///� ( (/'] <br />Y� M+'��t'" �t l.F'�'l�G. �1��L�°-J-�'�-'.�`_P✓�� ?,'�'...1�-�•( G-,�. I�l.i..t'--`�—C <br />v ��; � -� u�-u� U F=-�' �� ,� �., �f,�--� �. <br />�,..1 � � � � <br />� <br />1� <br />� <br />�� �� <br />� <br />�o� � �—� <br />l� - <br />� <br />! <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 />pRAINAGE <br />WqTER <br />DEPARTMENT APPROVALS <br />COMMONICBilONS <br />1RAF�IC <br />PL4NNINQ <br />STREET ' <br />�/(,��I(��- J�' LP_J�w %—�ia `cl�O <br />A P OVED FOR C�O T�[f GTION onre � / <br />� � ! � <br />rlvi'�OVEL].FC.O bT�iUciED - ;�°�� <br />DRIVEWAV S�CTION <br />I � <br />I" LIP <br />30" �— �3� <br />The unEBrsigneA owner hereby egrees to nold anE save hermless <br />the City ol Evere�t Irom nny nnd all claims lor Oamages, co515. <br />e�0ense5, or causes ol action thal may arise becausr oi �nstalla�ion <br />anC m2inlCnBnce o� IhC �mpmvemCni or oiher r�y:;��:�'-way use <br />M1erEiO aOP��etl lo� ane Imt�e� agre¢5 10 �emOv¢ same uyon noUce <br />iwm Ihe C�Iy antl lo replace pubhc pioperty aamageA I�e�e�y. <br />/ ' ' /������ <br />SiGNnTU�E O� A�PLI <br />IJ�Z GU11� T���L RD <br />aooness <br />m�.e,crP� c.,N �Sz7S <br />,3S�r b63ri 3�i1� 7SoD r,r �U <br />tELCPHONE NUM�[� 4LLENNAiE <br />�� r S'v -- - - <br />�1L <br />