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r <br />r <br />L <br />CVFIC�T <br />Q APPLICATION FOR RIGHT-OF-WAY USE PE�iMIT <br />� Type or prin� clearly wilh mk <br />_� PAESS HARD - YOU ARE MAKING COPIES <br />i� — - - ---_"'" �, ,.+d � . <br />JUBLIC WORKS <br />EVERETT, WASHINGTON �' -�1c� I� PERMIT NO. � <br />� C �- .��1`f <br />APPLICANT�UNDERSICaNED)AN IRM REPRESENTEO,IF ANY:_ <br />HEREBY APPLIES FOR PERMISSION TO <br />� AT THE FOLLOWING LOCATION �� � / ��� <br />I � <br />�, DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: ��� �' S s� <br />� <br />0 <br />� ; <br />i <br />� <br />l. �..� �: ` ,_ <br />��� � ... <br />� � �, ^�� ���:� c:, , <br />er� , <br />� ' . <br />` � <br />j <br />. _._..._:..__.,..e....: f <br />. . _._._... . - .�_..-'_�__. -. <br />�I <br />e��� � � ��1 ��� <br />� <br />., <br />(-� � � � �� �...��-� ��_ -+�� { , .`. .; i i „ ,_ <br />� �-n <br />, --�— C{ � L',, �, . ..� ��,� e_ 'f �'(�(:�•`., \O n <br />/' <br />.� ' ^ � �..J �' � ` i � 1 �A�� � Nl j � �! � � . � <br />, <br />' ' i a,�' ': + r <br />i.•. • .: .. <br />�, ' `1 I <br />��(i . - �r� � 4 <br />PERMIT IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HCIURS BEFORE CONSTRUCTION <br />ORnINAGE <br />DEPARTMENT APPROVALS <br />co�nmuH�cn� ioris <br />iflA�LIC <br />V�FNNING <br />SiqEET <br />�� <br />i c �. =( . 7— � �/Y/S"u <br />APPROVED FOR ONSTPUCTION / on1E <br />APPROVEC AS CONSiflUCTEJ oniE <br />� NITIAf. ',JSPFCTION PEQUESTED <br />� <br />r_.�. .� .. , <br />� ..�.. . ", �.�. <br />�C�s� ��y�a�.�f<</ <br />" "l/is <br />cll�k,- �y..vir, t-s •Si4•:-:� i <br />0 <br />�p /� i7ro�: Yl-C: cf <br />DRIVEWAY SECTION <br />I -- I <br />1�� LIP <br />j� 30'+ � _T3��� � <br />T�e unEersigned owner bereby agrees to �oIC anC save harmless <br />Ihe City ol Everett Iwm any antl ell claims lor damages. cests. <br />eepenses. or causes of action Ihat may anse Eecause oI ms�allabon <br />�nd mnmtenance ol t�e �mprovement or olher nght-obway use <br />nerelo appLea lo� and lur�lm agree5 io �emove same upon nol¢c <br />irom V�c Ctly nn� io re0�ace pu0i¢ pro�erty tlamagetl Inere�y. <br />_��. i � '. , . . <br />Cllv ZIP <br />TELEPnONENi�MOEP � � ALIEBNAIC��� <br />L'".� 1 'Y. . ) <br />�°„ ��(��� �fS3-3Z6� - <br />�EE "�" isia <br />l�BK a�- <br />'� <br />'1 <br />A� <br />� J <br />