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� <br />everetl <br />e <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PUBLIC WORKS <br />EVERETT, KASHINGTON <br />Type or print clearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />� <br />j PERMIT NO.� <br />, , i ,,. . .-, <br />1. <br />APPLICANT (UNDERSIGNI-D) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIE:i FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION � r/ �/ �/-` � <br />DRAWING (ONORK TO BE DONE) OR THREE PLANS ATTACHED: <br />��� -�.� � ..�-e � � <br />� �$.��� �;�u� �n.� ��,�_! �u�g <br />���� � <br />�- � .� �.2 <br />PERMIT IS VALID FOR 6� DAYS <br />COPY OF THIS APPLICATION TO BE Pf�STED <br />ON JOBSITE. <br />CALL FOR INSPECT�ON 259-881 1 <br />24 HOURS BEFORE CONSTRUC710N <br />DEPARTMENT APF <br />STREET <br />� ;% � �1� <br />APP E FOR� TION f TE <br />APPROVED AS CONSiRUGTED �ATE <br />��iLi'' � ' .. <br />� - _ ., � . _.._ ._ ... . <br />DRIVEWQY SECTION <br />I" LIP <br />��,� � �30,� <br />The untlersigned owner hereby agrces to hold and save �armless <br />Ihe Cily ol E�rerett Imm any and all claims lor Gamages. costs. <br />expenses. or causes ol action that may arrse because of instellation <br />antl maintenance o� ihe �mprovemem or o!her nght-of-way use <br />nerelo apphl'tl for ana futiher agrees to remwe same uDon not¢e <br />Irom Ihe G�y antl la re0late pubh� proDer�y Oamdgetl IhMc�y. <br />�E���- •��� ALTERNAtE <br />�/_'��r!G/ / l � -- <br />D/*E <br />;.-- — __.—_-_ <br />� <br />