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everen <br />� APPLICATIO�I FOR RIGHT-OF-WAY USE PERMIT <br />Type or prinl clearly wilh ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PC-RMIT NO._7 ZL <br />AF'PLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PEriMISSION <br />i e <br />ATTHEPOLLOWWGLOCi�?ION �'C.'�'J""A'!� (��)rtY��rY cf'� <br />DRAWING (WOHK TO HE DONE) OR THREE PLANS ATTACHED: <br />� � �����, <br />-���\ � <br />` , �i <br />� a � ��A I� <br />� � � <br />, <br />� <br />PERMIT IS �t21L9D FOR 60 DAYS <br />COPY OF TNlS APPLICATION TO BE POSTE9 <br />ON JOBSITE. <br />C�iLL FOR IIdSPECTlAM Z59-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />� <br />`)', �� U.1'./�. <br />DRIYEWAY SE�TION <br />\ +I'� LIP <br />3��� �- � 30" � <br />The undersigned owner hereby aprees to boltl antl save harmless <br />Ihe Cily ol Evereli Imm any antl all claims lor tlamages. costs. <br />e+pen5e5, nr Causes ol action �hal may arise beceuse ol inSlallaiion <br />antl ma�ntewncc ol Ne improvempnl or olher riq��-o�-w, y usi� <br />here�o apPhe[I br and lurihe� aqrees lo remove same upon no�ice <br />Irom Ihe Cily antl to replace pubhc property Aama9e4 Ihereby. <br />/� <br />. �'" <br />�='`r "�� _! G, � <br />fiAttlPE OF qPV�ICANT <br />�.3r�- F�,�� ,��.. �, �,. �, <br />AODRE55 ' <br />�✓��•��z; /.�.h �'i��<.'� <br />CIiY Z�p <br />�J S - �� I5S <br />TELEPMONE NUM1IBER ALIERr,�,IE. <br />..._L�J�//� ! i ����9 .. <br />On1F — J _____ <br />� <br />