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everefl <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS ' <br />EVERETT. WASHINGTON PERMIT NO..__.__—_ <br />APPLICANT (UNDERSIGNED) AND FIRM RErAESENTED. IF ANY: <br />HEREBY APPLIES FOR PERMISSION TO I n /• - r / <br />/ <br />AT THE FOLLOWING LOCATION /-�� % /I y 13- - // - F � - f, _ ,E, <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />J <br />G <br />AI �Ji�/1i �./ iY <br />1q I L <br />�Lr /- <br />,. <br />/NC.T <br />a/_= <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />L <br />DRIVEWAY SECTION <br />LIP <br />30 <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs. <br />e Ipenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other ❑ght-obway use <br />Hereto applied lot and further agrees to remove same upon notice <br />Ir om the City and to replace public property damaged thereby. <br />SIGPIAtURE <br />Of APMICANI I <br />-70 <br />ADDRESS <br />CITY <br />ZIP <br />. <br />` / <br />" - I <br />TELEPHONE NUMDER� ALtERNAIE <br />//% <br />1 <br />DAIE <br />JESTED <br />FEE <br />1978 <br />