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<br />� APPLIGATION FAR RIGHT-OF-WAY USE PERMIT
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<br />PHESS HA�u - YOU ARE MAKING COPIES
<br />PUBLIC WORKS � '
<br />EVERETT, WASHINGTON
<br />PERMIT NO. `�� �` � -'
<br />APPLICAtJT (UNDERSIGNED) AND �RM REPFiESENTED, IF ANY:_
<br />HEREBY APPLIES FOR PERMISSION TO �L--�-� �" ��tl'1 l C�� �� �� t a A f�� �'
<br />AT THE FOL�OWING LOCATIOK 7 2 Q� A� ��
<br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED:
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<br />PERMIT IS VALID FOR 60 DAVS
<br />COPY OF THIS APpLICATION TO BE POSTED
<br />ON JOBSITE.
<br />CALI_ FOR INSPECTION 2S9-B81 1
<br />24 HOURS BEFORE CONSTRUCTION
<br />SEwER
<br />pRAINPGE
<br />DEPARTMENT APPROVALS
<br />CO1dMUNICATIONS
<br />y�qTEq PLANNING
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<br />STREET
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<br />ORIVEWAY SECTION
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<br />jl" LIP ,
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<br />30�� i _ �_30"_�
<br />The undersigne6 ow�ar hereby agrees to hold end seve hermless
<br />Ihe City ol Everolt Imm any antl all claims br damages. cosis.
<br />ezpenses. ar causes ol action ihat may arise b�cause ol installalion
<br />antl mainlerance ol ihe improvemeM or other ng�4o1-way use
<br />hereto aOP��e4 lor and funher agrees m remuve same upon notme
<br />Imm the Cny antl to replace pubhc p�openy damagetl thaeby.
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<br />SIGNNipRE OF �PPLIC�NI
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<br />AODRE�S
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