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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />ue Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHINGTON PERMIT NO.$� �S <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION `- t 9 `�)��Z-C� v I I <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO PE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 2E;9-88 if 4 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWER u^!I COMMUNICATIONS <br />DRAINAGE i nil f IC <br />WATER :::111 111111 PLANNING <br />r�r•.I " ,I _ <br />STREET <br />yr <br />_3- FL <br />DRIVEWAY SECTION <br />j I" LIP <br />30' 30" <br />The undersigned owner hereby agrees to hold and save harmle:: <br />the City of Everett from any end 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 properly damaged thereby. <br />i <br />i <br />ADNATUR APPLICANT <br />6 <br />19 { (�3 y d <br />�S � <br />SX /02� �S 7SS <br />CITY <br />zP� <br />TELEPHONE NUMBER ALTERNATE <br />DATE <br />CONSTRUCTION/AS BUILT <br />FEE 1978 <br />