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I <br />CVCICfl , <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or- print clearlyDd PZ &Zoo <br />PRESS HARD -YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHINGTON 'Q / PERMIT NO.� 2 <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: >C4�6/(1,� f li)(141 EjYq COA✓S7• } <br />G •7 <br />HEREBY APPLIES FOR PERMISSION TO — <br />AT THE FOLLOWING LOCATION _ZOz0.._-7y�N _ <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR GO 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 />SEWER <br />DRAINAGE <br />SIREFI <br />DEPARTMENT APPROVALS <br />,S^[[NaMUNICAi lUNS <br />J_ 1r� <br />I\ <br />_.._ <br />.'. � eIANNINO <br />DRIVEWAY SECTION <br />I LLIP <br />I� 30r"I 1 30rr <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everell from any and all claims for damages. costa. <br />expenses, or causes of action that may arose because of installation <br />end maintenance of the improvemenl or other nghbol-wny use <br />herelo applied to, and further agrees to remove some upon notice <br />from the City and to replace public property damaged thereby <br />InE of A1Y iUNr <br />AGDnEss <br />Z o iaSH [�'-61 <br />:ITV lln <br />Iv-z/lY 7_9. 1-4S <br />TELE�V'RO/NIIMAL <br />E N DER ALTERNATE <br />it/1-7 - <br />Y <br />NSTRUCTION/AS BUILT <br />FEE 1978 <br />