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.,° XY/�` I <br />everett i <br />� APPLIGATION F�R FiIGH7-O�F-WAY USE PERMIT � <br />Type or print clearly wilh mk i <br />PRESS HARD - YOU ApE MAKING COPIES <br />PUBLIC WORKS i, <br />EVERETT, WASHIPIGTON PERMIT NO. `��-' - � <br />APPLICANT (UNDERSIGNFD) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PE�MISSION TG <br />ATTHEFOLLOWINGLOCATION,_,�O�iOZ — / �� v�".. .SE E�ercfi` �f/4 /87Qy� <br />6RAWING (K'ORK TO BE DJNE) OR THREE PLANS ATTACHED: <br />PERiV11T IS VALID FOR 60 DAYS <br />CO{'Y OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-$81 1 <br />24 HOURS BEFORE CONSTRUCTION <br />sEwE,� <br />oaoiNnce <br />WATER <br />STFEET <br />DEPARTMENT APPROVALS <br />COMl.IUNICAtIONS <br />iFAfFIC <br />PLANNING <br />�. <br />- � ZT- /i. <br />� � �, //i /�o <br />�� APPFOVED F R CO�STRUCiION -�. ��. —C.ire <br />�� <br />c��� � » � <br />,��� ,,� i -J / <br />�i�PF OVEO AS CON RUCTEO � �� o�tE <br />I <br />I � L.�i::�.i i � ����i'�.�. �.'�I�i�.. <br />DRIVEWAY SECTION <br />� � <br />+I'� LIP <br />30" 30" <br />7he un0ersigned owner hereby agrees to �oltl antl save harmtess <br />Ihe City of Everell Iwm any and all claims br tlama9e5. cosis, <br />expenses. or causes ol aclion Ihal may anse because ol mstallabon <br />:�ntl mam�CndnCe O� �he irtiprOVCment Or oihf� nghl-ol-wdy use <br />hereto apphetl b� antl luribcr agmes to remove samc uDon nobcr <br />irem �he City an0 lo replace pubiic O�Operty tldmagCtl ��CiCby. <br />�-�r�-o F/ <br />.�/' 7.�_�'l:�-��. iur�u�� l 5 <br />SIGNAiURE OF APP�ICANT <br />vo �o,r 4is <br />ADORE55 <br />�'ir� /G-.l 9�53 <br />a,� z��� <br />�Z7-6494- <br />iELEVHONE NIRdE3E� AtiERN�iE <br />Dn*[ <br />. _ . _ _ _ _ _ _ _ _ — _ . — _ . _ — . _ . _ . __ — _ _ _ _ .. — _ _ — <br />` 7978 <br />�� <br />