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eyerr•11 <br /> APPLOCATION FOR FIGHT-OF-WAY USE PERMIT <br /> Type or print clearly will Gni. <br /> ._ PRESS HARD-YOU ARE MAKING COPIES <br /> PUBL'C WORKS PERMIT NO. <br /> EVEHETT.WAFHINGTON <br /> APPLICANT(UNDERSIGNED) AND FIRM REPRESENTED.IF ANY:---- <br /> HEREBY <br /> NY: --HEREBY APPLIES FOR PERMISSION TO _-- —- <br /> AT THE FOLLOWING LOCATION _ . )0 - – 77 -& <br /> DRAWING <br /> -- <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> CONDITIONS <br /> 1. Ex.sting sidewalks, curbs and gutters are undamaged - any damage done <br /> to same during construction will be repaired or, removed ar' :placed to <br /> the P.W. Inspector ; satisfaction. <br /> f new riveways <br /> 2 to bet IS driveways <br /> athelexisting curbs and gutbe utilized for ters must,be totally CURB ed <br /> IS have <br /> and replaced at new driveway location - KNOCKING OFF OF CURB-JS NOT <br /> ALLY_ <br /> 3. All concrete removals mint be saw-cut or taken out to nearest expansion <br /> joint. <br /> DRIVEWAY SECTION 3 <br /> PERMIT IS VALID FOR 60 DAYS <br /> I <br /> ! COPY OF THIS APPLICATION TO BE POSTED I" LIP <br /> ON JOBSITE. <br /> CALL FOR INSPECTION 259-081 1 f'30i1' <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and esus harmless <br /> the City of Everett from any and all claims for damages, coals. <br /> evpensea,or causes of action that may arose becauso of Install.!,^n <br /> and maintenance of the Improvement or other Oghl ePWay Use <br /> herelo applied for and lurther agrees to remove same upon notice <br /> horn the City and to reptece public property damaged thereby. <br /> DEPA,iTMENT APPROVALS <br /> SEWER COMMUNIC01 iONS <br /> DRAINAGE TRAFFIC <br /> PLANNING OSIGNATURE 01�APPLICANT <br /> WATER PO 111 2 <br /> __._ -.. .. . ADDRESS �T,T /J�'�yE �y (//) <br /> STREET kI14 K�/Y•`�(/ _' /yes <br /> J rtY 21P <br /> `F,.�Wfi,_ Lt a� 0 827—Dy%� <br /> y'tCONS UCTiUN DATE <br /> TELEPHONE NUMBER AF ICRNATt <br /> ViED AS CONST UCTED _ nATE <br /> DATE <br /> CONSTRUCTION/AS BUILT FEE 1978 <br />