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z <br /> . ` — . . . , — . . ` � � . .r � <br /> � <br /> � ' � �'�b3 <br /> � everell ' <br /> � APPLICATION FOR RIGHT-OF-W/LY USE PFRMIT <br /> � Type or pnnt clearly with ink <br /> � PHESS HAFD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS <br /> EVERETT.WASHINGTON PERMIT NO. �a�43q <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: �1�J/�'.�S �'�}�l'7� � <br /> HEREBY APPLIES FOR PERMISSION TU �S �T `"'������� <br /> AT THE FOLIOWING LOCATION ��0 �����k'�'.� �� EGL/�Ci� ��O /BZO.3 <br /> ORAWING (WORK TO BE DONE) OR THHEE PLANS ATTACHED: <br /> ��P�fi���"��ir� b,ei9i�cl s To �= i�t/T��ic.�� Ta <br /> STa�°/1? �SY�'T.c/� <br /> � S ro,�r�2 u�i9 T�.�' �P�/rllo�"� irz�d�'��/�,C�/f�''�'�i9 <br /> To ,g,� i°i�,�,�.��i�i�J c�T�r�.��,�/� T,�.t/s�rP�'C1> <br /> Td-��l'/ST/,�/� S TD.e/yl s ys �.c/�? <br /> �- TaR� P�'a��.d.c'�b� S i T� /s �.G ss Tti��v �5%'��?.�_ <br /> ORIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS {�.� �–�i <br /> I I <br /> COPY OF THIS APP�ICATION TO BE POSTED � � i" LIP <br /> ON JOBSITE. `- I <br /> CALL FOR INSPECTION 259-881 1 i�30 �I' �Ir 30" ,� <br /> 24 HOURS BEFORE CONSTRUCTION The undersiqned owner hereby agrees �o hold antl sava narm�ess <br /> L tne City ol Everelt Irom any antl all claims lor damages, costs, <br /> ezpenses.or causes ol aclion t�at may anse Oecause ol installation <br /> antl maintenance ol the �mprovement or other neh4ol-way ese <br /> here�o applied lor and lurt�er �giees Io remove same upon nolice <br /> Irom ttle City antl Io replace pubbc propeCy Aamagetl t0e�eby. <br /> DEPARTMENT APPROVA <br /> / <br /> SEWER COMMUNICATIONS <br /> � ' <br /> DRAINPGE TRAFFIC <br /> i l^--�i ' <br /> ryqTEq NNING � �SIGNATURE OF A� L�CNM /� <br /> ., 5'��_;? i y , .i � 5� <br /> STREET AD�=E55 <br /> ��1�'�' i�iif',t��I/1 l_-�-Tb��__._— L� F;� 7f l-�o r� lj,2U `� . <br /> LITY 7 Z�P ` <br /> APi�ROVE ORC U 710N� T ��7' /� G� J-�S— /l,G�T'. <br /> ��//�/ TEIEPHONE NUMBEA ALiERNAiE <br /> --a� /? - �—�U _ <br /> APPROVED AS CONST UCTED �, r �/iE DntE � <br /> V <br /> CONSTRUCTION/AS BUILT FEE �978 <br />