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everetl <br />� APPLICATICJN FOR Rt�HT-��-iIVAY U5E PERMIT <br />Type or print cleziry with ink <br />PRESS HARD - YOU ARF M:.KING COPIES <br />PUBLIC WOFKS <br />EVERETT, WA;,HINGTON PERMIT NO. � � � <br />APPLICANT (UNDERSIGN�_ , JD FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIE.�'i FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION <br />l <br />DRAWING (WORK TO BE DONE) OR THHEE PLANS ATTACHED: �`'"���5�g� <br />CUNDI�ONS dama e done <br />damaged - any B <br />1. <br />2. <br />3. <br />Existing sidewalks, curbs and gutters are un <br />to same during constructic,n will be re�aired or, removed and replaced to <br />the P.W•Inspectors satisia:tion. <br />Eobe i n talled athe exUsting cu bs�and gutters must�be t t llylremoved ave <br />and replaced at new driveway location - KNOC��r�� �F— C- U- RH 15 NOT <br />ALL�_ <br />Ali concrete removals must be saw-cut or taken out 1:o nearest expansion <br />joint. <br />w t,o"�'_ _ <br />o�;a l ,�, /�l s�: <br />� u'//� � '�� I <br />aS ` .� ,Y � <br />��..�i <br />I�EFlMIT IS VALID FOR 13Q DAVS <br />CQPY OF THIS APPLICATION T4 BE PUSTED <br />ON JOkZ51TE. <br />�^„/11U.fL Pl'JR INSPEGTION :259-88t t � <br />24 HOURS BEFORE CONSTRUCTION <br />Df=PARTMENT APPROVALS <br />onniNncE <br />ns�nnn <br />WATER Lj '�_ '� <br />�,� <br />STREET <br />COMMUNICI.IIONS <br />rnnFFir, <br />�� rl G.Pl;A1NNG <br />� �._� r <br />i.; _ <br />Vi:� P ��q <br />. ,i J . <br />/y �t <br />(..�j � i,�' ��'� S'-. <br />l+PPROVEDfO'R A CTION _ at[ <br />. ff �_`�,: �:c� �•�,.. <br />.� ;-. � ,... ,. . � <br />APPFOVE'J n5 GONSTRUCTF.D onr� <br />DRIVEWAY SECTION <br />�— —'� <br />— I" LIP _ _ v�l <br />I � � <br />I��- ---- 30,� <br />Tne unAersigned ownen c�reb�� agrees 10 ho1J antl save harmless <br />ihe City ol Everett Imm any anG all �.:InP,u: /or damages, cosls. <br />expense., or wuses ol ac�i,n tha� n�s�.� arise b.cause ol installatir,n <br />cnd mamlenance ol Ihe Irt.provemenl or other righl-ol-way use <br />herelo applictl lor and fur�her agrees f� removc same upon noticc <br />Irom Ihe Cny antl to reptac^_ pubiic pmperty oamaqed ihe�eby. <br />S%��//�Ti_)1 Y r. �_�iL!-/ /n i� /NG <br />'%' ����.lt li�c, <br />/SIGNATUFE OF �Pa�ICqNT � <br />` �'�o :'r �/i �_ <br />ADOfiESS <br />��i���� i). l!J f� <)� i �i�!-� f' <br />Grv �.io <br />��'�`� � �/ %1_ _ <br />TELEPMONE NUMB/ER qLtEqNAIE <br />/.� /.� \ � <br />�* <br />� <br />