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rvrrett APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> �JType or print clearly with Ink <br /> PRESS HARD -YOU ARE MAKING COPIES <br /> PUBLIC WORKS PERMIT NO. 1� _I <br /> EVERETT,WASHINGTON <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESE RED,IF ANY: --------- <br /> HEREBY APPLIES FOR PERMISSION TOM:X ( <br /> AT THE FOLLOWING LOCATION ;).'D C ` I •fit - 1 <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: Nl <br /> I <br /> y <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS <br /> COPY OF THIS APPLICATION TO BE POSTED �� I" LIP <br /> ON JOBSITE. 30" _L3i <br /> CALL FOR INSPECTION 259-881 1 <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and save harmless <br /> the Clly of Everett from any end all claims for demages, costs. <br /> ea pensee.or causes of action that may arise because of Installation <br /> and maintenance of the Improvement or other nghl.of way use <br /> hereto applied for and further agrees to remove same upon notice <br /> from the CITY and to replace public properly damaged Thereby. <br /> DEPARTMENT APPROVALS <br /> SEWER COMMUNICATIONS //////I //�� <br /> DRAINAGE TRAFFIC <br /> PLANNING SIGN AfTUR,E� Or A� PPPLLIICANr <br /> WATER � / <br /> STREET ADDRESS / JJ <br /> PP <br /> 7�y/8o <br /> 46 <br /> AIE <br /> A PROVE .� OR C NS OCA-P1 TELEPHONE NUMBER ALTERNArE <br /> pl'P AS ON UCTED <br /> DAT DAT <br /> 1978 <br /> CONSTRUCTION/AS BUILT FEE <br />