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r • <br /> evereM � <br /> Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> v Type or print tlearly with �nk <br /> PRESS HARD - YOU ARE MAKING COPIES <br />, PUBLIC WOqKS �!� <br /> EVERETT.WASHINGTON PEAMIT NO.�_d�„J— <br />� APPLICANT (UNDERSIGNED)AND FIRM FEPRESENTED. IF ANY:__: � <br /> I — <br /> HEREBY qppLIES FOR PERMISSION TO_ `� , <br /> .4T THE FOLLOWING LOCATION ��� ��� (�r� � �f / <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: j <br /> K <br /> -? c. <br /> � ,!I!�E' . � <br /> — —�—�-- <br /> -- � <br /> Y Nc rcR <br /> . <br /> e_S��'u� � <br /> � c��`�Cw Na'�s�' <br /> • U� � <br /> � �)tJ119�L � � �o Fr <br /> � C�����,,.."`" �� <br /> �I G� <br /> � <br /> DRIVEWAY SEC710N <br /> PERMIT IS VALID FOR 60 DAYS � __� <br /> COPY OF THIS APPLICATION TO BE POSTED i" �IP <br /> ON JOBSITE. � � <br /> CALL FOR INSPE�'7'i�ON 259-881 1 I'��� 30" <br /> 24 HOURS BEFOFiE CONSTRUCTION The cndersignetl owner hereby ��rees lo �010 antl save harmless <br /> Ihe City of Everell Irom nny antl aIi claim5 lor tlama9es. cosls. <br /> e+penses,or causes o�action Ihat may anse because of m5tailalion <br /> an� mdm�Cndn[e OI Ihe improuemrnl Or O�lier nghbobway use <br /> nereto apphed for antl furiher agrees to�emove 5ame upon nol¢e <br /> Irom Ihe City ana to repl��e publiC proD�riy 4amage0 Iheieby. <br /> PARTMENT APPROVALS <br /> SEW[R COMNUWC4iiON5 <br /> DRAIN4GE iRAfRC / � <br /> i'��/Ji%� i��irr�-/ <br /> V9A'oR �'lAN ' NAiUREOF4PPL�Cr1Nt <br /> - /D z'/ 7 7�i�U� S <br /> srnerr .�unness � � � � <br /> �h, i%/�i��� .�/,�,'� ��,�"t/�;e�-�j�,-_LC/1�z,��'G�'/ <br /> APP VED F fl CO� T C ION � Dat .�5�'�y� � — <br /> / ���� i"yEVnONE NUMOEA �1UERNnLE <br /> c /��/ ./1 /�!%x�� _� >i� /Q --�---- — <br /> A D AS CON� ED / oarE' ua�re <br /> i <br /> y�^ <br /> CONSTRUCTION;T�S [JUILi �re 1978 <br /> _ �'.�'t. <br />