Laserfiche WebLink
• lVAf11 <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />VType or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IenF ANY: <br />` <br />HEREBY APPLIES FOR PERMISSION TO- I:X) V J IW 0� <br />AT THE FOLLOWING LOCATION /'d -I-r Un <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT N — <br />J <br />DRIVEWAY SECTION J <br />D �.. --'-I:-LIP ---� <br />1�30�}• a —---�+30rr <br />I the undersigned owner hereby agrees to hold and save harmless <br />J 'Pie City of Everett from any and all claims for damages costa. <br />,ponies or causes of action that may Anse because of installation <br />ind mAontimanCe of the Improvement at other oght-of-way use <br />Palo app Led for and gather agrees to remove damn upon notice <br />inn the City and to replace public properly damaged thereby <br />SI �N r Inf. Uf aPPLIUNI J � — <br />StnFFI <br />4L <br />rVIED N I1 natE <br />PROVED AS CONSTRUCTED VATF <br />' I/�1_ Ifd51'GGl IU;1 �;[.�1ULr;i CD <br />