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. - i <br /> � <br /> ievrrett <br /> � � qppL.IG�TION FOR RIGHT-OF-WAY USE PERMlT ; <br /> iype nr print cleady with mk i <br /> I PRESS IiAHD - YOU ARE MAKING COPIES <br /> IPUBLIC WORKS PERMIT NO._��\O�� I <br /> IEVERETT,WASHINGTGN I <br /> II <br /> I APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY�. ',I <br /> I� HEREHY APPL"-S FOR PERMISSION TO ��, <br /> I - <br /> � n f�` k/�7 I <br /> AT THE FOLI.D'!lING LOCATION �7DS �S�/ S� ���r6 9fJ7n / I <br /> i <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: I <br /> I � <br /> I I <br /> I II <br /> � <br /> � � <br /> I <br /> � <br /> I <br /> �I <br /> . i <br /> I <br /> I II <br /> I <br /> I <br /> � <br /> � <br /> � <br /> li <br /> i <br /> I <br /> I <br /> I <br /> i I <br /> I DRIVEWAY SECTION � <br /> II PERNi1T IS VALID FOR 60 DAYS � � I� <br /> COPY OF THIS APPLICATION TO BE POSTECI i" I.IP <br /> ON JaBSITE. �30_„� I <br /> �,30" I <br /> CALL FOR INSPECTION 259-881 1 i <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner here0y egrees lo hottl and save harmless <br /> the City ol Evereu irom any and all claims �or aamages. costs. I <br /> expenses,or causes o��ction Ihal may anse 6ecause ol in5iallation I <br /> and man��enance oi the improveme�l oi other righo-obway use <br /> herelo appbe0 �or and luriner�9ubl c,oropeoy dnmagetl�lne�eby. I I <br /> ircm Ihe Qty and to replace p 0 . <br /> DEPARTMENT /;PPROVALS <br /> ISEWER COMIdIINiLATIONS I �L, li <br /> �,t���y J) r . 3H�H , <br /> I pRAINAGE TflAfFlG _ /�' � �(,�� � <br /> I SI4NALUAE OF APPLICANT <br /> W4TER PLFNNING I <br /> 213 �- Fl1C�> l.A,�o A�� — <br /> noor+ess I <br /> � s.nee, . . � . . ; L 7 i il S� <br /> � �/ 7 F ziv <br /> �, i L ;�� iL 3_ �c ��.. <br /> �' _ � Zj1 -�Y�O ' <br /> APP V D F ON'TR il N �. � DniL a�iEaHn*E II <br /> '` ��7 TEIEPnONE NUMBER <br /> I J� //���� � �p/�G� `'�� ��^_.u^� <br /> �3i'"'i'I� �`iF=C/, onrE I <br /> � q OVE AS CONSTRUCT � DntE , <br /> I '�T� lJ "' CONSTRUCTION/AS BUILT �ee -- 1978 <br /> � <br /> 1 <br />