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A. _ <br /> Ll <br /> APPLICATION FOR RIUNT-OF-WAY USL PERMIT <br /> Type Or print clearly with ink <br /> I•RESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS .791.2 -4 7 <br /> EVERETT.WASHINGTON PERMIT NO. <br /> - <br /> APPLICANT(UNDERSIGNED) AND FIRM REPRESENTED, IF <br /> / 1 <br /> HEREBY APPLIES FOR PERMISSIC,N TO <br /> rT 1� <br /> GNOni%7� '5 <br /> AT THE FOLLOWING LOCATION_ _. 311 E^'0 -" i>t.• <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> Ce-iL�A't.-T.,.ti (,u""l�t�.� " <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 r)AVS <br /> CQPY OF THIS APPLICATION TO BE POSTED L I" LIP <br /> ON JOBSITE. II 30" <br /> 1 30" <br /> CALL FOR INSPECTION 259-881 1 ' — � <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and save harmless <br /> the City of Everett from any and all claims for damages, costs, <br /> e.penslu.or causes of action that may arise becLise of matallabon <br /> and maintenance of the Improvement or etre, nghbof way use <br /> hereto applied tot and fulther agrees to remove dme upon notice <br /> from the City and to replace public property dAdleged thereby. <br /> DEPARTMENT APPROVALS <br /> SEWEn COMMUNICATIONS <br /> DRAINAGE TRAFFIC <br /> yOf <br /> WATER PLANNING SIIOONATLIVE OF APPLICA <br /> N <br /> T <br /> STREET ADDRESS <br /> L <br /> ��J -29 1 CITU ZIP <br /> rPITRUV N U 1 , — DATE <br /> J_ 9 ei—T.5-3 — .SST, P i <br /> TELEPHONE NUMBER ALTERNATE <br /> _ <br /> AI'FHVTp OA!,-(,,)t ;11111GiC0 r'.tl f'AR <br />