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-.� , �-�v� ;w <br /> �, � � <br /> everen I <br /> I a APPLICATION FOR RIGHT-OF-WA" �3SE PERMIT II <br /> � Type or pnnt dearly with mk I <br /> �� PRESS HARD - YOU ARE.MAKING COPIES � <br /> �i PUBLIC WORKS I <br /> I EVERETT.WASH�NGTON PERMIT NO. � � <br /> I�, APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY:"�hiPS �AT�pP�� (�uN�� L., ��i 1.Y�/� �N�P �o�J <br /> il � / � <br /> J � �j •, L�or c rf'�e !7 'Jr 7 i'�n �/� /���"[, �., r� -�1.. � <br /> HEREBY APPLIES FOH PERMISSION TO�/� " � <br /> I ��� � � /'/Vfi' C /�� �' �' r f � � / � — i <br /> IAT THE FOLLOWING LOCATION ��`�r�f - �T��� I ( �G � – �b II <br /> I I <br /> �I DR 4WING (WORK TO BE DONE) OR THREE PLANS��D: <br /> I /�,� � 7��� � <br /> I �--r/ C./ �.I'�����2�e�^�G-�l I� <br /> � <br /> I I <br /> � JJ7;�� �1 a ;D � �%f w �'d/-e c � � �• ;� � � d � <br /> / <br /> � ��� n� a ���'i �a �+al� �� "� (� o '�P� a ��. � o E <br /> �j /�/ �i � d�"J�— <br /> � �V d�-�- t�: (c-t c�,� �e I d-i-G ., � . :� i / I <br /> � <br /> i I <br /> 11 � � r <br /> � <br /> , � .� -.� c�_ <br /> , � <br /> '� , �1 �� I <br /> , � <br /> i I <br /> II 'li <br /> � <br /> � � <br /> , <br /> I� �� <br /> � DRIVEWAY SECTION <br /> i � <br /> PERMIT IS VALID FOR 60 DAYS � �I <br /> I <br /> I COPY OF THIS APPLICATION TO BE POSTED i" �iP �I <br /> � ON JOBSITE. <br /> I CALL FOR INSPECTION 259-881 1 30 1�30 � <br /> �� 24 HOURS BEFORE CONSTRUCTION I ` <br /> 7�e un0ersignetl owner here6y agmes to holU antl save�ormless � <br /> i ine Cily ol Evere51 Irom any antl all claims lor Oamages. costs. i <br /> expenses,or causes ol aclion thal may arise Gecause ol mstallation <br /> , anA maintenance ol Ihe improvemenl or Mher nghl�obway use i <br /> I� �em�o applieG lor antl further agrees to remove same upon nnt¢e ��, <br /> r Irom Ihe Ctly antl b replace pub6c property damagetl Ihere�y. 'I <br /> I DEPARTMENT APPROVALS �� i <br /> � � <br /> II JEWER COMM�NI NS <br /> II pRAINAGE iRAFFIC � / <br /> u��; ���.�-.._� <br /> � WqtEq PLANNING SIGNATURE OF APPLiCANT I <br /> J4 vZ ly �A� SG� ', <br /> I STREET ADDRE55 /� I <br /> I � ��rir �{ !/� ��1�� �, <br /> � CITV ZIP � <br /> O.PPR VED FOR CONS U . O �ATE �J /� 9(,�3 V <br /> '��!1i�'r�ONE NUhIBEP ALTERNF!E <br /> � <br /> . <br /> � ��� , !=� /—f;,�/ -/G- '%y — - <br /> - ---- --�--- -- - .. <br /> ,H; -; �:.,� <br />