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everell <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or p�int clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLI� WORKS <br />EVERETT, WASHINGTON PERMIT NO.��_ <br />APPUCANT (UNDERSIGNED) AND FIRM qEPRESENTED, IF qNY: � I✓' �> � - - .�� <br />FiEREBY APpLIES POR �ERMISSION TO �-� _ /.i�- *�' � _ <br />r / , <br />.�i.. ..r :i . _ .;i _ ,y �✓ � <br />. r �� :7 <br />AT THE FOLLOWING LOCATION - �� � � � � � -� i � r' ' . <br />�-- rc �r �. � t y <br />DRAWING (WORK TO BE DONE) OR THWEE PLANS ATTACHED: ��,� �; <br />e�c �'. <br />�.J� <br />1 �1 <br />, .l� / v <br />. \� ', I y +� <br />y ` / �, ,;�,1 . <br />�,! � <br />d <br />,. <br />ti' <br />:�,'/c ! , <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 />sEv,�r� <br />ORAINFGE <br />V:Ai[R -- <br />DEPARTMENT APPROVALS <br />V' <br />COMMUNiC�TIONS <br />iRAFFlC <br />FLANNiNG <br />CONSTRUCTION/AS E3UiLT <br />I< < / <br />i ! . .� � ; r <br />. .. . . i . . . . J . <br />J��' � — \ <br />DRIVEWAY SECTION <br />r� j I" LIP —�� <br />�30" � _ � _ 30" <br />�i— <br />The undersignetl owner hereby agrees tu holtl ana save harmless <br />�he Ci�y oi Everefl imm any antl all r.iaims br tlama9es. costs. <br />erpenses. or causes oi aclion Ihat may arise because ol msta:labon <br />dnd maintenence ot �he improvemer�,i or olher ngni-nl-way use <br />nereto dpphCtl �m antl lurlher agrfe5 lo rCmove samC upon nohce <br />f�Om Ine Gly and lo rC01aCe publiC prOperly tlamagetl �hereby. <br />�_ ......,, .il1 <br />��� <br />AV�LiCNNi � �� <br />CILV .^^� 11 .J ZIP <br />^ �� <br />TEIEPMONE NUMpEA — � qL1ERNaTE <br />OATE <br />