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ev-_ � <br />� APPLICATION FOR FtIGHI'-UF-WAY USE PERMIT <br />Type or print clearty wdh mk <br />PRe`SS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHiNGTON PERMIT NO. �� �� <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION <br />ST <br />AT THE FOLLOWIriG LOCATION I Z � J 2 I' � <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: �'��j7���—$� <br />�C i� �- _ <br />�� <br />�r�� ���� <br />�f� <br />/_ / <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTF'D <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE C�NSTRUCTION <br />SEWEfV <br />DRAINAGE <br />WATEfi <br />DEPARTMENT APPROVALS <br />COMRtUNiCATIONS <br />• iRAFi1C <br />� <br />PLANN W G <br />STREEr . • .__ 1 . — � -- <br />� <br />,; :, <br />.2 �<;: >. ;/ �� <br />APPROVEOFO CONSTRUCTION��� ppr� <br />+PPROVEDA ONS flUCTE ' � i, � p,r� <br />cc�vsT�uc riot�!;,;s eun_ � <br />DR�VEWAY SECTION <br />�- ---� <br />�— +I" LIP —�� <br />� .1 <br />�30�� � 30" I <br />'1 <br />The untlersigned owner hereby agrees b holtl antl suve harmk:v <br />Ihe Cily ol Everell Imm any nntl all claims for damages. co5is. <br />expenses, or causes ol aGlion Ihai may anse beamse ol inSlallaiion <br />and mainlenance ol the improvement pr ot�er righLol�way usc <br />hereio aophetl lor antl luriher agrers lo remove same upon nobce <br />Irom Ihe Gly and Io �epiace pobbe propa�tY d��r�igetl Inereby. <br />� � �_. <br />SipNAIUR O�qPPtIG/•NI <br />�uv ` _ �✓� �,r� <br />aoor+ess <br />���f� y�l�� <br />fRv ZIP <br />�,'' % ` y� % � �j�� � 7 % y <br />LELEVI ONf NUM1IpCf AUEqNA�[ <br />� �� O V <br />oalc - -- <br />-- --, ��s <br />