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everetl <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVEflETT, WqSHINGTON -� /' <br />•'/ /// PERMIT NO.� <br />APPLICANT (UNDERSIGNED) AND FIRM FEPRESENTED, IF ANY:��IZI' /�i ✓L/�fI/IG�i <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION� (1 _G/' ����. <br />DRAWING (WORK TO BE �ONE) OR THREE PLANS ATTACHED: <br />'�-,� -�..� � ..�.e � ` ' <br />�— �.���,� � � o ��� <br />, /u �¢.�.�� c�J <br />� � � �f'-I �u�.l� <br />�-T" �'�'�'�`z <br />� � �L �� <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPE�TION 259-881 9 <br />24 HOURS BEFORE CONSTRUCTInN <br />DEPARTMENT AF <br />SiREEi <br />/ L <br />�/I � /L i ` `' <br />••• � •• • �S� • i <br />/ <br />APPROVED AS CUNSTRUCTED Da*E <br />DRIVEWAY SECTIpN <br />I _ � � <br />t ��� UP � <br />� <br />� 0�� � .T 30 � I <br />The undersigned owner hereby 2grees lo hold anC save harmless <br />Ihe Cily of Evereit Irom any and all claims lor damages, wsls, <br />erpenses, or causes ol action Ihnt may arise because ol inslallation <br />antl mamtenancc ol Ihe imprpvement pr o�her nghl�ol-way use <br />liere�o applietl lor and lurlber agrees lo remove same upon nobce <br />Iwm �he Ci�y antl to replaca pu�li� property tlamagetl Ihemby. <br />�/ �(/�� !� �M' <br />T[tEPHONE NUhipEA ���� A�iEFNAIC — <br />i %� ��c�/—�-1� <br />oarc – <br />REFERENCE COPY �EE <br />__ .._ .... _ — <br />_ _ . _ __„__ ._ <br />__ _ ------ �g <br />s.._ rnK_htt3�'y'�'�,• �4�' --�'� `n"='T�` ..8 <br />. . .r_ . yf?k_.n. ......- . _ . <br />L� <br />� <br />