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<br /> APPLICATION FOR RICHT-OF-IMAY USE PERMIT
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<br /> ' PRESS HARD - YOU ARE MAKING COPIES
<br /> j PUBLIC WORKS PERMIT NO. ' � /.���
<br /> IEVERETT,WASHINGTON � i
<br /> , APPLICANT (UNDERSIGNED) AND FIFM REPFESENTED. IF ANY: �L'�4�1 ���/�� -- I
<br /> I HEREBV APPLIES FOR PERMISSION TO �� �V� Tfl(_l� U���YC.. I�A �L� ti / D� _ �°��''�F2 �
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<br /> ORIVEWAY SECTION I
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<br /> I PERMIT IS VALID FOR 60 DAYS l� —.� �
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<br /> ICAPY OF THIS APPLICATION TO BE POSTED L + i" uP —��
<br /> I O I 30^ I _I_30,�
<br /> I CALL FOEi INSPECTION 259-8�1 1 ly �i'
<br /> 24 HOURS BEFORE �ONSTRUCTIOPJ Tha unAersignetl owner �ereby agrees to holtl entl save harmless
<br /> Ihe Ciry ol Evorefl Irom any antl all claims br damages. costs.
<br /> expenses,or causes ol oclion Ihal may anse because ol ms�allalion
<br /> antl mainlenance ol Ihe improvement or olher nghl-of�way use
<br /> I herclo appbetl Im an0�ur�her agrees Io remove sdme u0on nohce
<br /> irom I�e Cily and to replace public pro0etly tlamageU Ihere�y,
<br /> I DEPARTMENT APPROVALS
<br /> � 3-�-5-&d ,,,p � �
<br /> SEWER GOMMUR'CATIONS
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<br /> DRA�N/GE TRAFFlC �'/'// /� / / /'� _'Ci'`��� '�I
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<br /> �I'.,f1-4Wil�� i �
<br /> I WATER PLANNING SIGNAIURE OG Af�PLIC4Ni
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<br /> SiREET ADORE55
<br /> • �N�ucu�aD � In/faSN. CJ'�.� �
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<br /> APPROVEO FOR GONSTRUCTION DnTE /'/_/� �J "� ��3 �
<br /> LELEFnUNE NUTA�Efi /+LLERNFIE
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<br /> APPROVE�AS CONSTRUCTED onrE DnTE
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<br /> � INITIALINSPCCTIONRtQU�STED «E 1978
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