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- ':,�.,. <br />>�4.� <br />I <br />e�vfrett <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVEFETT, WASHINGTON PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESE�vTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION TO ��n $I/�.� �C �%� Cj0/� PrP fC Z��� �+C 'v4y5 <br />AT THE FOLLOWING LOCATION <br />/ N <br />/�{' � S �J ? Sf . J . I��, <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />� `�i,,n,,,-,E-Q ,�:� , , rr.�� -t,� ���r,-,��T ��e G�/� ��y _GcJ'�c P�c <br />(/ <br />� �— y�,��,1- �� <br />v <br />62 ; �r�r.P% � <br />� � �. <br />; �c, - , ,- ;; � ,� _ <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />�ALL FQFi INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWEP <br />DRAINAGE <br />WATER <br />DEPARTMENT APPROVALS <br />COMMUNILATIONS <br />TRAFiIC <br />PLANNING I <br />; <br />STREET /�}� <br />ilY � � � ""v�� � � `J �(J �. <br />PR VED FOR C N TPU TION � DArE <br />�-� ✓ G / . � `��j <br />.PPROVED AS CONSTRUCTEG DNTE <br />CONSTRUCTION/AS BUILT <br />5-�air-c, :;'-. � <br />DF'VEWAY SECTION <br />� � <br />I'� LIP <br />r30 � 'IT�-'1 <br />The undersignatl ownar �ereby agrees to holtl antl save harmless <br />Ihe Cily ol Everett irom uny and all cleims for Cemages. costs, <br />e�Fenses. or causes ol ection that may arise because oi installalion <br />antl maintenance ol Ihe improvement or o��er righl-ol-way use <br />hereto appbed lor ana lurther agrees to iemove same upon no�ice <br />Irom Ihe City an0 to �eplace pubiic proOe��Y damagetl Nerehy. <br />`✓/V� _ __ <br />GN U F APP E�T <br />� � IUD� .57� � <br />a � ES�.���` �.va . y <br />s�2o <br />��337-3��i 33 Z�-,.$%�,2 <br />TELEPHONE NUMNER ALTERNATE <br />�` 25 �� <br />DRl <br />