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eye-Ptt <br /> APPLICATION FOR RIGI ,T-OF-WAY USE PERMIT <br /> Type or print clearly with Ink <br /> II <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS PERMIT NO.. " ? <br /> EVERETT, WASHINGTON <br /> APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY <br /> HEREBY APPLIES FOR PERMISSION TO_ <br /> AT THE FOLLOWING LOCATION ! 77__?`_.. Z, -5.�--J-e EuGre 9gZo3 <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS <br /> COPY OF THIS APPLICATION TO BE POSTED �I" LIP <br /> ON JOBSITE. <br /> CALL FOR INSPECTION 259-8811 <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agreesd hole and save harmless <br /> the City of Everett from Shy and all claims for damages. costa. <br /> expenses.or causes of action that may arise because of installelion <br /> end maintenance of the Improvement or other Pghl.of-way use <br /> hereto applied for and further agrees to remove same upon notice <br /> from the City and to replace public property damaged thereby. <br /> DEPARTMENT APPROVALS <br /> SEWER COMMUNICATIONS <br /> ORA AGE <br /> TRAFFIC <br /> WATER PUNNING L< Of APPLICANT <br /> L <br /> STREET ORRESS <br /> atv ^ <br /> :AP <br /> P OZOAS <br /> U I N pA 7—1 '/�C _ <br /> •ELEPRONE NUMBER ALTERNATE <br /> IiSTnUCTE�— <br /> pAIE DATE <br />