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evereR <br /> APPLICATION FOR RIGHT-OF-WAY USE PE9MIT <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 REPRESENTED, IF ANY..'/'./maI^y'/' 406 <br /> HEREBY APPLIES FOR PERMISSION TO/ l/L�� Q�•VIX.� �ry�'/�C J �ES/!�c�yE�' <br /> AT THE FOLLOWING LOCATION/or ey JJEsl/� <br /> DOE C19S7- OF /30 _ 76 7H 5-LV- <br /> DRAWING <br /> , ,DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: _ >h <br /> ilf <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS <br /> COPY OF THIS APPLICATION TO BE POSTED LIP <br /> ON JOBSITE. � y- <br /> CALL FOR INSPECTION 259-661 1 L30" 13� <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and an"harmles, <br /> Ilio CITY of Everell from any and all claims for damagescosta. <br /> expenses,or causes of action that may arise because of installation <br /> and maintenance of the Improvement or other light of-way use <br /> hereto applied for and further agrees to remove same upon notice <br /> DEPARTMENT APPROVALS from the City and to replace public properly damaged thereby. <br /> r <br /> SEWER COMMUNICATIONS �� <br /> DRAINAGE <br /> TRAFFIC <br /> WATER PUNNING SIONA E r APPLICANT O <br /> O s <br /> STREET ADD <br /> �- Z CITY ZIP <br /> ALOPTICIVED FOR CON U OATS S07" ✓ -7 <br /> TELEPHONE NUMBER VV ALTERNAIE <br /> AVPffKW AONSYRUC ED SpATE� DATE <br /> CONSTRUCTION/AS BUILT IEE 19 - <br />