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!V!f!n <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />`' Type or print clearly wlth mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO._�_ <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTEG, IF ANY: iC ,'���L. � �-tt-% J�., —_l ��� �.. �.,:'.Y <br />�%�� � q y— <br />HEREBY APPUES FOR PERMISSION TO ��ut�t-�L cZ� .��� �� /� � Y. ct c i� � � l� I��-,�- .�L� -Cr�'" <br />: ('.� <br />—7 � a v � <br />AT THE FOLLOWING LOCATION 1 � �Ci � — �l ��� ; I.� � � ��-L-�`cl—C-t - /��l��. i� -I��-� � ' <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHEG:�� 3'��'�n `/ � <br />�— i' f. <br />( :', <br />f �� t <br />% � <br />� � � ' ' f <br />- '� E � <br />/ /'y C G <br />__— � G µ <br />.____'_ -__-. <br />.— —._ ___._.'__..._._ <br />..y,_ — ---� � <br />�_f_. �.-��..---� � _ <br />' � ' � . . ; <br />, % . �/ �7/� p <br />� , <br />�i� "'' — <br />�� <br />PERMIT IS VALID POR 60 DAY� <br />COPY OF THIS APPLICATION TO BE PnSTED <br />ON JOBSITE. <br />CALL FOR 1,'eSPECTION 259-881 1 <br />24 HOURS CiEFORE CONSTRUCTION <br />� <br />DRAiNnGE <br />DEPARTMENT APPROVALS <br />u,,.,r.,y�wFaP�.r:., -. ,. <br />G <br />'�TRApFIC <br />,,t�� , hH�d <br />� -' �' X��I 8 $ <br />� � ��«�- L� ���°� �� ��� _.� ��'�-�`C <br />APPRO EO FOR CON£TPUCfION �ArE <br />� <br />APPROVED AS CS1NiTRUCTED �niE <br />�- �,.��, __I��!"'��"iIONREQU�.-_:, <br />� <br />a <br />� �; �'� � �,� �6�,,��i6+,� <br />� � �o�> � y7 �,.,. <br />� <br />DRIVEWAY SECTIUN <br />� � <br />�— j I" LIP 71 <br />� <br />�30�__ _�30"_I <br />�� <br />The untlersiynetl owner hereby agrees Io holtl antl save hannicss <br />Ihe City of Everett Irom any antl all claims lor damzges. r.osts <br />e.penses. or cmrses ol aCiion inul may nnsr because ol installahnn <br />��nc m�inlendncr ui Ili�. unyrovempni ar oihei nqni-ot-�y,��� i. <br />.,_rrtu aPPLeiI ',� anJ lininr� .� �o.n.: ;n r� �no.c SJ,nb upon noh[:�• <br />Ill:ll� • ��. (��.f. :It:(� I[: f � i:l(�. �•..ihliC {�r�)f�e'r�/ :i�lllt:ltl�•t� I )e.l�.tll <br />�� /�:. ��. i l <br />SiGN��URE OF at�o�iCnM " ' u , � <br />�� I l � - '� /'=-� _ % ��� <br />noo,[r+ s5 <br />i. /— � 'J <br />/ � ( U L � ���fi- f� � �t _ <br />„�� <br />�'i.5 -.�'�i`,�' � <br />iE�.E�'nONE NU�.�BEB a�iEHN.�tE <br />�� –T�(� —<�� <br />DA1E — – <br />1978 <br />