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everttl <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />�j Type or print clearly with ink <br />PREYS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON <br />PERMIT NO./3yT <br />APPLI^ANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />le, S A C GI✓S7 L C <br />HEREBY APPLIES FOR PERMISSION TO /�CJ/&frl-^'� - — <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORN TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DRIVEWAY SECTION <br />ILIP <br />30„ <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all clain•.s for damages. costs, <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-ol-way use <br />hereto applied for and lurther agrees to remove same upon notice <br />from the City and to replace public property damaged thereby. <br />riry ZIP <br />ALTERNATE <br />///Z kl7ir <br />