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everefl <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with ink f <br />PRESS HARD - YOU ARE MAK'NG COPIES <br />PUBLIC WORKS PERMIT NO. w 33 _ <br />EVERETT. WASHINGTON <br />APPLICANT UNDERSIGNED) AND FIRM REPRESENTED. IF ANY: --- --------- <br />HEREBY APPLIES FOR PERMISSION TO__-- -- <br />AT THE FOLLOWING LOCAT ION_ _ 1706-- <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />CONDITIONS <br />That portion of the driveway within the :right of way <br />must be paved. <br />No vehicle parking on 112th will be allowed during <br />construction. <br />Power of Attorney required. C�- <br />PERMIT IS VALID FOR 60 DAYS <br />COPl` OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-887 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />WATER <br />STREET <br />n Al <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />TRAFFIC <br />PLANNING <br />DRIVEWAY SECTION <br />jI'I LIP --I/0 1� <br />The undersigned owner hereby agrees to hold and save harm,ess <br />the City of Everett from any and all claims for damages, costs. <br />e.penses. or causes of action that may arise because of installation <br />and maintenance r' she Improvement or other fight-of-Waf nie <br />hereto applied for and further agrees to remove same upon no'ice <br />from the City end to replace pubkc property damaged thn•eby <br />SIGNATURE OF APPLICAN' <br />lobos 39" Dr• S,,E• <br />ADDRESS <br />6Vf/ly"40 u.w 48�os/ <br />CITY zip <br />3 37— y017 _ <br />TELEPHDNE NUMBER /� AITERNAIE <br />�' ? — ev <br />