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4 <br />everefl <br />� APPLICATIOfV FOR RIGHT-OF-1f✓R,Y USE PERMIT <br />Type ar prinl clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON <br />PERMIT hO.�L,� <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY:�f/"p ��/Nc _;i __ <br />HEREBY APpLIES FOR PERMISSION TO��'�S G lh/� -/�ri Lr OL /� T=y ST B� TtiC/� S/./ ;yc ST�J JT <br />�.Si�'= 57� `Jt� %!'�r Pva'PoS: oF /NST/��-�C.�xG V/�F��i� SfVJf%J /Nc� <br />' %� > � V � - � ���> 7v ��/ ?�'7 J <br />AT THE POLLOWING LOCATION _ � y� r� �� S/• <br />DRAWING (WORK 70 BE DONE) CR THREE PLANS ATTACHED: <br />� <br />. i � �;,,✓.� . _ - ._-t <br />\ ': _�' �� _J.?'�. � _ �_// ?/, .__ <br />, � � <br />:� y <br />-'i�_..✓ . -....,-C.�.. J : LC•!!✓ <br />.� ,�. � .. _ . .. <br />_!� ; o <br />/ �:r. <br />Co,vz�7'/o,u.s ��s� ia /�v.w� <br />ou�`� <br />/� r"�-. _-� �� R� Gr-v5� <br />C% � ga��d �: a� �.1�. <br />fn? <br />z 5rr�c� 7v � r�.¢ru!-�� � <br />C�� U� ��'Pt--�'. 1..1� L-�N'"C <br />. ,._✓ �' ..._,L <br />� �\�.�.P�— �tTLc�' F�A7cLN �5 �l� '�c_ <br />1�.o`r ��?�k14c-.T �� Pc'tL C�'r`-i �A�1-�bPcP1�5 <br />� S`ttz�r� COIaS'�vc.`-r�o�..� '� L�llul-s 'Co ��.�. <br />-f� �L Y(Fv 4T.:�7 <br />PERMIT IS VALQD FOf� 6� DL\iPS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />�ALL FOR INISPECTIOPI 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />sec,rn c r..,�r�ic n H��- <br />� �� <br />L'�+niNnGE 1 %.vviC <br />i:ait r �'�.q^:r�iN4 <br />;,�,�E, — -- —. <br />oRivEwnr sEcriorv <br />� � <br />�� f I„ LIP <br />�30�__ __�30"_I <br />,� <br />Tue undersignetl owner here�y agrces lo hol� antl save harmless <br />�he City of Everett irom any antl all claims for tlamages. cosis. <br />enpenses. or cduses of aclion !hdi may drisr pecause ol insidllabon <br />antl inain�Cnance a� �he imprOvemen� Or o�hcr righ4oLway ust� <br />❑orilo Opphetl lar antl lurtner agrees to remove same upon ncUcu <br />Ironi fic City antl to rcP��4!• public pruprrry� �arnago� P�crot�y <br />�^ r'—� <br />a>2�k�-_ <br />r� <br />SiGNAtURE Of s�n�iCnNi <br />lSox iJ`% <br />a��nEss L I 1- c�C <br />��I U �C ' ( T C~O / O 2. �,S � <br />a,v ziv "_ <br />�5.5 Fl0 �.3 <br />LELEPMONE YUMFER p�tERNAiE <br />�:� � i <br />�,,,,E <br />��_ . ,�,s r.;i_�i�r ,E� — --- —is�a <br />