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<br /> � APPLICATION FUR RIGHT-OF-WAY USE PERMIT
<br /> Type or prnt clearly wilh ink
<br /> PRESS HARD - YOU ARE MAKING COPIES
<br /> � PUBLIC WORKS cq ,
<br /> EVERETT,WASHING?ON PERMIT NO. D �� �� �
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<br /> �I APPLICANT (UNDERSIGNED) AND FIRA1 REPRESENTED, IF ANY: C �%L A/�T �-cJJ T _, _ �,
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<br /> � HEREBY APPLIES FOR PERMISSION TO � �-�� -"��"' ? S AS�/�i��- � 17fh�/'✓G U'N y
<br /> I�� AT THE FOLLOVJING LOCATION V�Z / � �!G-�'C�e SO/7 /�O� E,ieie.{'� ��, /8203 �.
<br /> � DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED:
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<br /> JRIVEWAY SECTION
<br /> PERMIT IS VALID F�DR 60 dAYS � —� y �
<br /> � �
<br /> I COPY OF THIS APPLICATION TO BE POSTED ��� ��p o `r
<br /> ON JOBSITE. ' ,� � �30,� � �
<br /> �I C�1LL F�R APISPECTION 259-881 1 f`J���
<br /> I I 24 HOURS BEFORE CONSTRIlCTION The undors�9ned owner hereDy agrees lo �oltl enC save harmless i � �
<br /> Ine City ol Everelt Irom any antl all claims �or Damages. wsis. �—'� �'
<br /> c.pen;es.or causes ol action Ihnt may arise because ol installahon � r �.
<br /> � untl mdinten2nce 0� Ih2 m�provemenl or o��er njhDof-way u5C I F� :
<br /> � ne�eto appLetl lor antl Wtlher agrees to remove same u0on nobee � C
<br /> , bom �he City ana to re0lace O���Im p�oVerty Gamagea the�eby. � � �
<br /> EPARTMENT APPROVALS __ ; ;
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<br /> ' SEWER COIAGNNICAi `NS
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<br /> �, WPTER PIAN� SiGNp'iURE Of APO�i N I/ i -
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<br /> '. . _ . . ;.'r.TIOI�:',^.3 GUILi -- -- 7978
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