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<br /> � APPLICATION FOR RIGHT-OF-WAY USE PERMIT ,
<br /> Typc or print clearly with inh
<br /> II PRESS HARD - YOU ARE MAKING COPIES
<br /> � PUBLIC WORKS I � I
<br /> EVERETT,WASHINGTON PERDAIT NO. �� �! �' �1��'_ �
<br /> , AFPLICA�T (UNDERSIGNED) AND FIRM REPRESENTED, �F ANY:_ � �� ' � '' � � �
<br /> I HEREBV APPLIES POR PERMISSION TO � �� ' � '�' �'� '� � �_ r � I �/I L I i � � �1 �
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<br /> AT THE FOLIOWING LOCATION �/� ' j ,�- �
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<br /> DRANJ;NG (WORK TO BE DONE) OR THREE PLANS ATTACHED:
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<br /> IORIVEWAY SECTION
<br /> � PERMIT IS VALID P�R 60 DAYS � -----+I
<br /> COPY OF THIS APPLICATION TO BE POSTED i" LIP �
<br /> ON JOBSITE. _ �
<br /> CALL FOR INSP�eCT10N 259-881 7 �30 T L30"
<br /> i 24 HOURS BEFOFiE CONSTRUCTION 7he un0ers.gnea ownei here�y agrees to hold antl save na�miess I —�
<br /> t�e Ci1y ol Everetl Irom any a^tl ail claims for tlamages, casis.
<br /> I eepenses.or causes ol aclion II .may arise because ol mslallalion
<br /> antl maiNenancC ol Ihe improvemeni o� ollw nqh4o4wav use
<br /> I here�o applietl lor antl lu��ncr a9rees Io�einove same u0on notice
<br /> Irom Ine Gty antl �o replace pubhc dmpertY tlamagetl Ihem�y,
<br /> DEPARTMENT APPROVALS I
<br /> � SEWER �� WMMUMI��N � , �
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<br /> DRAINAGE �'. I �i '�/� INPFF C�- t' �- 7:� ,'/�
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<br /> WATER �_.� PIANNING �� `� SIGNATURE�QF APPLILANTr
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<br /> l���I . .� ADORE55 �
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<br /> � AP ROVEDFORCONSTR4! TION�.�., _ � 9 E .� , �/ — �� .� �// ' � '� �1�i'
<br /> � � ` �� -""' �' � LtLE�'nUNE NUAIBEF /�TERNATE
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<br /> APPROVED 4S CONSTFUCTEU ���TE M�E � _ � ,
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