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I . —� < l ,v��7 � <br />i I. everett I <br />' � APPLICATION FOR RIGHT-OF-WAY USE PERMIT � <br />� Type Or prinl Clcarly wi�h mk � <br />PRESS HARD - YOU ARE MAKING COPIES I <br />1 PUBLIC WORKS <br />I EVERETT, WASHINGTON PERMIT NO. ��/3eS' I <br />1 APPLICANT (UNDERSIGNED) AND FIRM REPRESENTEO, IF ANY: _ I <br />' HEREBY APPLIES FOR PERMISSION <br />AT THE POLLOVII�G LOCATION �4��2 — 9�� d�r„ SE E�e�c �5`. /.r/a . 981a7/ <br />DRAWING (W'ORK TO BE DONE) OR THRcE PLANS ATTACHED: <br />PERMIT IS VALID �a+R 6() DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBS{1"E. <br />CALL FOR IMiSPEGTIONB 2�9-881 1 <br />24 HOURS BEFORE CONS'fRUCTION <br />DEPARTMENT APPROVALS <br />SEWEfV <br />� DtirIINAGE <br />INATEli <br />STPEET t% � <br />COA161UNICnTIONS <br />iqpFFIC <br />PLANNiNG <br />i� 1.�/t <br />APPROVED F R CO STRUCTIO�i 1--%p��O <br />� <br />�, - <br />j `�1�, . /i�` _ i'-�'/ <br />iAP OVED AS CON IRUCTE� � �� � � DqrE <br />I <br />� ' �:(ll �C. � r..�)i., i I.�,�.I �. <br />DRIVEWAY SECTION <br />� � I�� LIP � <br />� <br />�, 3�" �30�� <br />The unaersignetl owner hereby agrees to hol7 antl save harmless <br />I�e Cily o( Evere�� Imm any antl all claims lor damages. cos�s. <br />expenses. or causes ol aclion tYa� may arise b^cause of installation <br />antl maiNenance ol ihe impruvemenl or otM1er ngN-ol-way use <br />heretu applie0 lor antl lurlher agrees to remove same upon nobce <br />Irom IM1e Qly antl to rep'ace publ¢ proper�y tlamagetl Ihe�eby. <br />�/�,�^%�/TD Ll <br />��'%�a� ..'/.�� ct�r�u.�,�lS <br />SIGNAiURE OF �PPIiCANi <br />�O �o�Y 4/9 <br />nooaess <br />,Ci✓�/�,,! 9f'�:�3 <br />CiTv ���, <br />�Z7-049¢ <br />�ELEPMONE Nl16fBER qLiERNniE <br />