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rev crrR <br /> APPLICA-TION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or DI rG clearly with Ink <br /> PRESS HARD - YOU ARE MAKING COPIES / <br /> PUB[IC WORKS PERMIT NO. <br /> EVERETT,WASHINGTON r <br /> APPLICANT(UNDERSIGNED)AND FIRM REPRESENTED. IF ANY:_ E S <br /> HEREBY APPLIES FOR PERMISSION TO_ E, A ` ZL.LI ' KC \ <br /> IF LU AY — <br /> AT THE FOLLOWING LJCATION �!1--V r"� r<, �p� �F zi,L — <br /> DRAWING (WORK TO UE DONE) OR THREE PLANS ATTACHED: <br /> I <br /> L „y1 <br /> -- DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS +i <br /> COPY OF THIS APPLICATION TO BE POSTED I" LIP <br /> ON JOBSITE. 30" 1 <br /> CALL FOR INSPECTION 259-881 1 <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and as"harmless <br /> The City of Everett from any and all claims for damages, costs. <br /> ,.pensee.or causes of action that may ens,because of Installation <br /> and maintenance of the Improvement Or other nghhof-Way use <br /> hereto applied for and further agrees 1Q remove same upon Police <br /> from the City and to replace public property damaged thereby. <br /> DEPARTMENT APPROVALS <br /> SEWEP COMMUNICATIONS <br /> OITA N—AG E -_—_— TRAFFIC <br /> PLANNING SIGNATURE Or APPLICANT <br /> ADDRESS - -- -- <br /> S'BEET <br /> Crtv Im _ <br /> AP OV FO S U IbW- ----4"E - <br /> TEtEPHONE NUMBER ALTERNATE <br /> APPROVED AS CO RUG ED DATE DATE <br /> NITIAL INSPECTION REQUESTED IEE 1978 <br />