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� <br />� t4e eft . <br />� APPLICATI N FOR RIGHT-OF-WAY USE PERMIT <br />Type or piinl clearly wilh mk <br />. , PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVEflETT, WASHINGTON <br />APPLICANT (UNGERSIGNED) AND FIRM REPRESENTED, IF <br />HEFEBV APPLIES FOR PERMISSION TO <br />��.�.(.�_r�'C! <br />AT THE FOLLOWING LOCATION <br />q /� A-D <br />A <br />j h� <br />�, � <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTAC� <br />� <br />��� <br />�� ���� <br />�� <br />� <br />� <br />PERMIT <br />., � ��i 5��---�I�_� ����-�:�:� <br />�� —�,Cas;h� <br />L L / (� -jI- C� � <br />'�(� , J� I c�-� �� /EC_7 d"'� I/�.� U—v� <br />(r� 1 G�- c <br />�"��,�.� S-+��-d.�� �C � r >>' � Gj ��{ � �1 <br />�.� <br />�'�r�,',n<<��In,,., vPCjU����` <br />bG�'' <br />IT IS VALID FOF3 60 DAYS <br />COPY �JF THIS APPLICATION TO BE POSTED <br />ON JOESITF. <br />Cl'.1LIL FOR IN'SPECTION 259-881 �1, <br />24 HOURS BEFORE CONSTRUCTION � <br />DEPARTMENT APPROVALS <br />SEwE� --� <br />pRAINAGE <br />C,OA!MUNiCATIONS <br />iRAFPIC <br />P�ANNiNG <br />�" ;� � ` <br />51R 1 i— <br />(j!�)����__ ,� . . �,�� U � � <br />q pWt,VE� DFOR WNSTRUCTION ��� <br />APPROVEDASCONST�UGTED �A�E <br />'/� <br />� �� s-� ��� f�'�- <br />� � C�� �.�� �� � <br />ORIVEWAY SFCTION <br />I" LIP <br />30'' � �-30 -� <br />7he undersigned owner hereby agrees to holC and save hannless <br />tne Cily ol Everell imm any antl all claims lor damages. cosls. <br />eapenses, or wuses of aclion �hat may arise because of inslallahon <br />antl maintenance ol 1he improvemeni or olher ngM-O�-�+'ay u5C <br />herelo aVPhed lor antl Iorihe� agrees to remuve same upo�� notice <br />imm Ine Cily and Io replace publ¢ pmOPrty tlamaged tnere�y. <br />� �r <br />/ <br />. -/I �_-� .1 :' - <br />,-" S�NATURE O� AP4'LIGANi ( �/� <br />% �5 �� .� _ /y ` 4�� � _ <br />ADD�ESS <br />f-' ��" !``�'%G`� — <br />cirr r zia <br />� , � ` ���� PLiERNATE <br />iEIEPI{ONE NUMplR <br />1�/� � /�.� --- <br />ORIE <br />.,I ;"- . .:(;'-�',=1j=`� r([ <br />� � � : <br />� . . �' � � a�.ts ..r.. <br />�'x ` - '_'v„�+a <br />.. . � . -. , ' `i_ - _ ' ' <br />