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evcretl <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or print nearly with mL <br /> PRESS HARD -YOU ARE MAKING COPIES <br /> PUBLIC WORKS U <br /> EVERETT,WASHINGTON /� PERMIT NO. <br /> 137 <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: �n�N/F_5C •E/�GV7 _ __ <br /> HEREBY APPLIES FOR PERMISSION TO b✓Ok'K- IN JefGry I- <br /> AT <br /> AT THE FOLLOWING LOCATION _( • `�-� — V �' "� <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> -De,g1A)RUc -7-6 8:, crus rAI-�D /9 .5 <br /> sHF,J= T Y eV-y B,V 019A)M - 3-/8-a6 <br /> Tv ,0� 6 <br /> U5 -F /7,x7.b <br /> f�GL OT/V�e ,�jlyH�D� l��% ��l>o1Pat/r�l�iUiS iD <br /> i <br /> i <br /> i <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 6O DAYS <br /> COPY OF THIS APPLICATION TO BE POSTED �— I" LIP <br /> ON JOBSITE. <br /> CALL FOR INSPECTION 259-881 1 <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hole and son harmless <br /> the City of Everett from any and all claims for damages, costs, <br /> ea pensee.or causes of action that may arise because of installation <br /> end mamtenance of The Improvement or other right-of-way use <br /> hereto applied for and further agrees to remove same upon notice <br /> i - <br /> DEPARTMENT APPROVALS from The City and to replace public property damaged thereby. <br /> "'A'" COMMUNICA NS <br /> DRAINAGE - TRAFFIC <br /> WATER / PLANNIN tier AIunE or AICANT <br /> STREET A'Mllll <br /> 144!41 <br /> CIT), ZIP <br /> APP ED 'ONSPRULIJUNDATE 654- Z1,0:57 1131 <br /> TELEPHONE NVRmfA ALTLh:I;lc <br /> .",,Lis.. - - <br />