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everen APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> TYp s or print clearly with ink <br /> PRESS HARD- YOU ARE MAKING COPIES <br /> PUBLIC WORKS PERMIT NO. <br /> EVERETT,WASHINGTON <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED,IF ANY.�r••�' ^ ' rA f ----- <br /> HEREBY APPLIES FOR PERMISSION TO <br /> AT THE FOLLOWING LOCATION 2So9 BCJ � J C—' �V 2d3 <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: Sp'wla) - i�NRadcN <br /> Efr1IS �oHPtE'►�� <br /> CONDITIONS damage done <br /> I, Lxisting sidewali<s, curbs and gutters are undaf•, rem - any 6 <br /> to same during construction will be repaired or, removed and replaced to <br /> the p.\V. Inspectors satisfaction. if new <br /> d for new <br /> 2. to beinstalledtithe existing curbs be and nd gutters homes, <br /> tfbe totally�removed have <br /> and replaced at new driveway location - KNOC1:ING OFi OF CURL] IS NOT <br /> ALL_ Oma- <br /> I <br /> w-cut or taken out to nearest expansion <br /> 3. All concrete removals must be sa <br /> joint. <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR So DAYS f. — <br /> COPY OF THIS APPLICATION TO BE POSTED <br /> 30„ I _�. <br /> ON JOBSITE. I 30 <br /> CALL FOR INSPECTION 259-981 1 <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and sews harmless <br /> the Cay of Eyerelt from any and all claims for damages. costs. <br /> e.penses.or causes of action that may arise because of installation <br /> and maintenance of the improvement or other righl-01-Way use <br /> and further agrees <br /> ve same uPon <br /> ice <br /> from the CIsapplied ot <br /> d to replace public property damaged Theretby. <br /> DEPARTMENT APPROVALS <br /> COMMUNICATIONS <br /> SEVIER <br /> TRAFRC 1/\�L / <br /> DRAINAGE r �— <br /> 91GNATUREOrA LICANT <br /> WATER PLANNING <br /> l. 'A D BS��— <br /> STREET � �� <br /> ZIP <br /> OAT —��— r ALTERNA E <br /> TELEPHONE NUMBER <br /> C UAl/ <br /> p /411 TRUCTED _GAT �l <br /> CONSTRUCTION/AS BUILT rrE <br /> 1978 <br />