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� 'J <br /> � <br /> �i, everen <br /> � APPLICA'�ION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or print clearly�nith mk <br />� PRESS HARD - YOU ARE MO,KING COPIES <br /> PUBLIC WORKS j � <br /> EVERETT, WASHINGTON PERMIT NO.__�.L,�_ <br /> � ��� fi; 1Z r :- T r <br /> � APPLICANT (UNDEFSIGNED) AND FIRM REPRESENTEG, IF ANY:__'- . !.%/I ii.,_� �� <br /> HEREBY APPLIES FOR PERMISSION TO G� C f�1�"� /� /'J) T�� Fn�:� T/I_- �'��/jI�/l � � <br /> � �UII,.'�J c p /� / . /_ ! . , / i ,� / ./,' I:t;(,�r'//_ - � /f� <br /> ,� _s ) r'o : dt-f,�F�= <br /> .. , <br /> AT THE FOI_LOWING LOCATION � ����.J _ ���� J � �� ��= �� . <br />� <br />� aRAWING (WORK TO BE DOP�E) OR THREE PLANS ATTACHED: <br />� <br />� <br />� �� <br />� c <br /> I <br />� 4.� � <br /> 1 vl , <br /> t� <br /> i ' �) � .�� <br />� � <br /> I � '* <br />� � • <br />� • <br /> 1 <br />, ,� � <br />� <br />�, � <br />, . _ <br />�, ; <br />� , � �� <br />� <br />� <br /> ORIVEWAY SECTION � <br /> PERMIT IS VALID FOR 6a DAYS � _� i <br /> i COPY OF THIS APPLIC.�TION TO BE POSTED i" �iP <br /> ON JOBSITE. <br /> � �q � T <br /> CALL FOR INSPECTION 259-881 1 I"---�1'-- •�30 j <br /> 24 HOURS BEFORE CONSTRUCTION -,; <br /> The un4ersigneA owner hereby agrees to holtl antl save�armless , <br /> ihe City o� E�oretl irom any and all cloims lar tlamages, tosls. <br />' expenses.or causes ol:iction Ihat may anse because ol instailahun - <br /> antl maintenance of ihe impmvement or piber nghi-oi-way use I <br /> hereio,pph�a for antl lurther agrees lo remove same upon nohce ' <br /> Irom Ine C�ty anC to replace pu�l¢ pwperty aamagea Ihereby. <br /> DEPARI'MENT APPROVALS <br /> SL-WER JOMMUNICATIONS ~i <br /> I <br /> �RAINAGE . iqqFFlG , /�f �]' I / / � <br /> l..f� // 7 <br /> �� /�-�` ✓ .� '_:._.//i;!�l.Lr../ <br /> I WATER PLANNING SIGNAiURE OF qPO�ICPVT I �, <br /> SiREET - /�.:�� "����c/C�IZ� '� l��tll�� `���3i' l j li <br /> .�onaess <br /> � �/i•%�✓,•ioc n //%�SN 1f� �_; � I <br /> r,rtr // / Z�p <br /> APPflOVE�FOR CONSTRUCTIUN DATE �7'� - C,,��� � <br /> TELEVHONLI;UMtlEF ALiERNAiE �� <br /> /��.�f /9,�� '� � <br /> APPROVED AS CONSTfLCTED ❑ArE p�rE — � <br />�— ---- - - - r'. ' <br />