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m <br />�"�«� <br />!Y!fllf <br />e <br />. i �"T.-x,-�. <br />. .: . ^.::.:' <br />APPLICATION FOR RIGF�T-OF-WAY JSE PERM�T <br />Type or print Clearly with mk � <br />PRESS HARD - YOU ARE MAKING COPIES ' <br />PERMIT NO. �� �� <br />PUBIIC WORKS <br />EVERETT. WASHINGTON <br />APPLICANT (UNDERSIC,NEU) AND FIRM REPRESENTED, �F <br />HEREBV APPLIES FOR PERMISSION <br />AT THE FOLIOWING LOCATION _. <br />0 <br />r <br />'> > � �._� <br />DRAWING (WORK TO BE DON�) OR THREE PLANS ATTACHED: <br />� �j�l�L S <br />� � <br />v �.,2% �� <br />. �.. <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION' TO BE POSTED <br />ON JOBSITE. � <br />C4LL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE GONSTRUCTION <br />. <br />/ <br />_. --� <br />DEPARTMENT APPROVALS <br />SEWER <br />DR�INIIGE <br />WATER �- <br />COMMUNIC�TIONS <br />TflAFFIL <br />PL�NNiNG <br />STHEET <br />1 � c�ti�, � _�, � _ � <br />A OVE F R R � N DATE ; <br />_ � . , <br />5C. <br />ORIVEWAY SECTION <br />� � <br />I'� LIP <br />r� 30� �T� �T� 30���' <br />The urMenigneA ownx hareby eqreea to holA �nE ��v� Mrmleas <br />tha City of Everott Irom any end all claims lor tlamepu, wsta, <br />expensea. or �euse� ol aetion t�at msy arlsa Eaceuae ot Ins411elion <br />enC mainbnence of ihe improvemen� or olher nfl�t-o4way use <br />nereto aoGLeA lor ana lurtller agrees to remove aeme uoon nobce <br />Irom tna C�ty ana lo re0iace public o�opertv aamaqetl thereby. <br />/, <br />..�� _ ��✓�,-��.�1�G <br />SIGNATUR OF �PPIICANT <br />/.� / %� / r i/. �. T. SG — <br />�oonEss <br />GL/F�''L7T— fi�='C' ? <br />GTY.3 r� E y 9.5'- . z" � <br />TELEPHpNE NUMBE.p /.LTERNATE <br />�% - i"/ _ t�1/1 _� <br />