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evered <br />� APPLI�CATION FOR RIGHT-OF-VVAY USE PERMI'T <br />Type or piint clearly wilh 1nY. <br />PRESS HARD - YOU ARE MAK�NG COPIES <br />PUBLIC WORKS PERMIT NO. 71 /a 0 7 <br />EVERETT,WASHINGTON ;—� ^ <br />�G U13 ��T l.� � ST� i�1 — <br />APPLICANT (UNDERSIGNED) AND FIRM REPFESENTED, IF ANY: 1/ � <br />HEREBY APr'LIES FOR PERMISSION TO <br />W � <br />AT THE FOLLOWING LOCATION <br />g(o/4- 8 ��� �E ' <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />:� f1-� G'u�",�, �z �A ��� � �` � /�T��e�'Rz. s�l���igG r� <br />� �r9�� o�' cU � i d � /� r /� � �.��1�1 � <br />�- s T�i1J,D�7,� ,1��u� ��� 7'/�7�1J rD �� /1s�.1� - <br />PERMIT IS VALID FOR 60 DAYS <br />COPY O:� THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR iNSPECTION 259-88'I 1 <br />DRIVEWAY SECTION <br />jl" LIP <br />L _l_ 3� <br />��, 30" � i <br />24 HOURS BEFORE CONSTRUCTION rne unaersiqned owner hereby agrees Io hold and save harmless <br />f E tt Irom any antl all elaims lor damn9es, eos�s. <br />APPROVALS � <br />�v <br />� �,� - <br />►��_ .1/ -- � <br />•-. , . . . �. <br />APPROVED NS CONSTRUCTED oATE <br />�Ihe Ci�y O �ere <br />erpenses. or causes o� �c�ion Ihai may atise because ol inslallahon <br />antl tenance oi Ihe imOmvement or olher nghl-ol-way we <br />n ��E�lietl br antl lurlher a9rees 10 remove same upon nabce <br />�, � C 1 I�om�,i� Cily antl Io-reDlaw P��bhc p�opeety d�ma9etl Ibereby. <br />�(� � i <br />C'� ' � <br />�Y ' . .. 1� } 'T <br />C��Y CL�..`�.•`r+c���7—�'f `-�a"�<i _ <br />����"` � SIGNATl1RE OF APPLILANT <br />� / Z G 'r'7 � 9 s 7'���U � /l� � <br />aoonEss <br />/l„-/lG�,�. �:h 9a� 33 <br />CITv Z�P <br />cor�:srr�ucTior�/��,s i,�ui!_r <br /></66-;33� <br />TELEPHONE NUM�Eq NLiERNNiE <br />