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� <br />t <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PUBLIC WORKS <br />EVERETT,WASHINGTON <br />Type or print clearly with ink <br />PRESS HARD - YOU AfiE MAKING COPIES <br />PERMIT NO.�'i�- <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANV: <br />�oS/i�Ql�' � �7' `Oi1PrF�L d� �e w.�S <br />� <br />HEREBY APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING <br />; r� <br />LJ Q.�� _-;- �f, �.�J, <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />" " _ �' , - _ 4' /�: .-* -, , . , � _ , ' . ., . ` <br />�!� : � ,�_ �.� <br />n J' <br />_ � , / ; <br />_.;:— -��� f—',�i � i:,;.. �'''.'-l.�l i.,� -- <br />,�.� . -�-,�, vr�o`-�. ;,. t- � <br />% <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CpLL FOR INSPECTION 259-88 7 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVAIS <br />SEWER ' COMMUNICATIONS <br />�'. ` <br />DRAINAGE - iRA'FIC <br />,..q ..`n <br />WATER �.-•' :': PLANNING <br />STREET ' -. . � - � .•. <br />�• � � � .� � ' .. <br />APPROVED POR CONSTRUGTION �AtE <br />APPROVED AS CONS fRUCTED DnTE <br />REFERENi,E COPY <br />� �! ��.0 ,- <br />DRIVEWAY SECTION <br />��_ I" LIP <br />�30'� _�_30" <br />The undersigr.e0 owner hereby agrees lo hold and save harmless <br />Ihe Cily ot Everett Irom any and all claim5 /or Eame9es. cosis. <br />expenses. or causes ol action that may arise bewuse oi instailation <br />and mmntenance ol Ihe Impmvemenl or olher ngni-ol-way use <br />hareto apPlred lor antl �urtlier agrees fo remove same uoon noUce <br />Irom ihe Gty antl Io replaCe publit property tlamage7 Ihereby. <br />� /u, . G`I"�f�� <br />GN U F Aa C � <br />�vo-'s �'.` � <br />�� E55 ���D <br />�.va � y <br />� 2�P <br />��? � 3375��2 <br />�3. �i7�i <br />TELEPHONE N1IMBER hLiEFNNTE <br />� � 5 �U _ <br />DAT -- <br />Fee 1978 <br />