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everetl <br />e <br />APPLICATION FOR RIGHT-OF-WAY U�E PERMIT <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COFIES <br />PERMIT NO. 7�// a 7 <br />FJBLIC WORKS <br />EVERETT,WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTE�, IF <br />HEREBY APPLIES FOR PEHMISSION TO <br />AT iHE FOLLOWING LOCATION � U � �� � — — C I � �� � • <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICA710N TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />� <br />OFI.INAGE <br />WATER <br />SiFEET <br />DEPARTMENT APPROVALS <br />GOMIdUNiGATiONS <br />TRAFFIC <br />FLANNING <br />APPROVEO FOR CONSTRUCTION , oATE <br />APPROVED �S CONSTRUCIED DATE <br />CONSTRU'�TION/AS BUILI' <br />DRIVEWQY SECTION <br />�— �� <br />j I" LIP � <br />� <br />30'� � _3���_ � <br />The undersigned owner hereby agrees to �uld antl save harmless <br />tl�e City of Everetl Irom any antl all Uaims lur da� .ges, cosls. <br />eKpenses. or causes o� action ihat may anse �^�-, .+C ol mslallabon <br />dntl mainienTnce ol ��e improvement or olher n9h4ol�way use <br />nere�o appi�etl lor and lunner a9rees to remove same upon novice <br />Irom ihe C�ty ana Io replace pu�hc properiy Oamayetl memhy. <br />G N�f/ Uc� t7 .!% . y� U.36 <br />CItY ��� �� �_� LIP <br />TEL�E rvUM�E� �j �I�ERNAIE <br />� �3 �/� <br />oarE <br />1978 <br />