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APPLAOATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with mK <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION FO-:E u C v <br />��Y�g533 <br />PERMIT NO. Tk <br />h ' 2 <br />AT THE FOLLOWING LOCATION .—�' CCvQ <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />;= t�xu 5 ICJ V� <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />DEPARTMENT APPROVALS <br />t <br />COMMUNICATIONS <br />TRAFFIC <br />DRIVEWAY SECTION <br />I" LIP <br />L 30" 130" f <br />The undersigned owner l.ereby agrees to hold and save harmless <br />the City of Everett from any and all dsims for damages. costs, <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the impruvement or other right-of-way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to rep- -.a public property damaged thereby. <br />STREET <br />PLANNING <br />APPROVED �Oyi ONS FlUCTIprI --- DATE <br />NATURE OF APPLICANT <br />ADDRESS n <br />CITY ZIP <br />