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r- <br />L <br />evereN <br />APPLICATION FOR RIGHT-OF-WAY <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS tt <br />CVERETT. WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY: <br />USE PERMIT <br />PERMIT NO, <br />HEREBY APPLIES FOR PERMISSION TO 14&Z`'t 1XJ .el v-1 l ,14 14,1,01 clod <br />AT THE FOLLOWING LOCATION ���� L — ��-��Y �?F %t-E%fT i• <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />* ",r-e P./fl Hf` dfU lSif ic�S <br />� <br />6,/�/.2� U� 5/lazl/ 4, .c`' � ,�'=ed',4 i T ��1 a� <br />a. <br />>a �.c- %a <br />4( F iGG mi / <br />.?%36 <br />e Tp <br />,�'/CzHT pf" GI//QY <br />UNDt,e y ���iv, <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 />DRIVEWAY SECTION <br />I" LIP <br />L30'�.__ I <br />The undersigned owner hereby agrees to hold and Bove harmless <br />the Coy of Everett from any and fill claims for damages, costs. <br />",panties, or causes of Action that may arise because of installation <br />n"d maintenance of the improvement or other rem -of -way use <br />hereto applied for and further egrets to remove some upon notice <br />from the City and to replace public property damaged thereby. <br />'1 <br />SIGNAI'URE 01"APPLICA011 <br />Arlon ss _ <br />Cilr zir — <br />/ - Ile-) <br />TELEPHONE NUMBER _T ALTLRNAIE <br />/ -1n -� <br />pAIE i <br />INITIAL INSPECTION REQUESTED <br />