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� <br />everEM • � <br />;� APPLICATION FOR RIGHT-OF-WAY USE P�RMIT <br />� Type or print cbuly with ink <br />! PRESS HARD - YOU ARE MAKING COPIES <br />i <br />� PUBLIC WORKS <br />' EVERETT, WASHINGTON <br />P[RMIT NO. 7y '%JL" <br />APPLICANT (UNDERSIGNED) AND F;flM REPRESENTED, IF ANY: /�'� � '- " - � T[: hP _ <br />� � <br />HEREBY APPLIES FOR PERMISSION TO - ' ^ <br />9 �j �� -cr S�- ' t.�� . <br />AT THc FOLLOWING LOCATION �� O l `-� -- <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PEiRMIT IS VALID FOR 60 DAVS <br />COPY OF THI� APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL �OR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />DNAINFGE <br />WAIEP --�— <br />COMM1IUNiCATiOhti <br />Ii�pFflC <br />P�pNNING <br />SfpEET <br />, <br />�j, �(�'� �t,'2�_�-. � �� � J�- ! / <br />!APVROPED FOR�pN��RUCTION �AT� <br />APPROVED AS CONSTRUCTE� DarE <br />DRIVEWl+Y SECTION <br />�_�LIP � <br />�30 30 <br />The unaersigne� owner nereby agrees to hola antl save harmless <br />Ihe Ciiy ol Everetl Irom any and all claims lor Oameges. costs. <br />expenses. ur causes cl action I�ai may arise because o� installalion <br />dn0 mTrniCndncP ol IM1e improvemen� Or Othef r�ghl-01-w2y u5e <br />h.ureto appLed for antl puIIiei agrees lo rempvB 59me upon nohce <br />Iwm ine Ci�y ano to replacc pubbt property Damn9etl Ihereby. <br />/j��y �� ��� <br />/�" � <br />�j.''' ��_�` <br />SIGNNiURE Of APPLIC�M <br />'��� _ � — �.' �� o' I . T./ <br />:_i.' _.; " �. �o_ . � �G`.1/ � <br />CRY .� ... 21P <br />1 � ` <br />�y3 .,- j..-.,. <br />TELEPMONE NUMBcR NLTEFNATE <br />�C, ������ <br />D4iE ! <br />2'.'�r.�,Y i.: y. . T ..: �� �. �, ti u: ♦ '.i�W • 'w.�y� y� �'.. . '. �'. � . . . .' <br />, .. , , . "a` t , :.i , .. � ^ � . � . • . <br />, <br />'�Y „ �. ., .. , . <br />� . , . ,. . . .. , ' <br />.. . . _. , .-.. .� � . , :. �..... . <br />