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APPLICATION FOR RIGHT-OF-WAY <br />Type or print clearly with ink <br />Ll <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHINGTON <br />USE PERMIT <br />PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPREES+ENTED. IF ANY Y11SAWA9 <br />HEREBY APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS. 'FORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWER <br />—- <br />DRAINAGE <br />--- <br />WATER ---- <br />STREET <br />PtANNiNG <br />/ V� <br />AP R VE F R CONS ION DATE <br />APPROVED AS CONSTRUCTED DATE <br />DRIVEWAY SECTION <br />�1'r LIP / II <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damagescost&. <br />PI <br />penes or causes of action that may tests because of Installation <br />and maintenance of the Improvement or other nght-of way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged thereby <br />E 01 APPIICANI <br />�QX <br />J- <br />W.,4 <br />3 <br />