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evelctl <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO.�Z <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY. 1L. S, T C. GIVS7 11ir' <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION .46?/�<J <br />DRAWING (WORK 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 />APPROVED AS CONSTRUCTED DATE <br />REFERENCE COPY <br />�.S <br />DRIVEWAY SECTION <br />I" LIP / I <br />I <br />�.3G' •T• -� 1 .30" <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs. <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the Improvement or other right-of-way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged thereby. <br />—FxzzN <br />TELEPIIO E NUjDER ALTERNATE <br />DATE <br />1978 <br />