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ki <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with ms <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHINGTON C�/ PERMIT NO. <br />� <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY:.t --?STJA0!` fe-il /iA":'S All <br />HEREBY APPLIES FOR PPRMISSION TO. 00 T-V G <br />AT THE FOLLOWING LOCATION '"' 1 rl. <br />DRAWING (WORK TO BE DONE) OR <br />THREE PLANS ATTACHED: <br />!PERMIT IS VALID FOR 60 DAVS <br />COPY OF THIS A0PLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWER COMMUNiCALUN. <br />DRAINAGE I Par r Ic <br />WATER PLANNING <br />STREET / <br />STREET <br />DRIVEWAY SECTION <br />I" LIP <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims lot damagescosts <br />orpenses. of causes of acllon that may area because of installation <br />Ind maintenance of the Improvement or other nghLOf way use <br />n eleto applied for and further agrees to remove same upon notice <br />nom the City and to replace public property damaged Thereby <br />gz.7-o�OX <br />TELEPn0NE NUMBER ' Ac1ERNAIL <br />DA (Err— a — --- - <br />CON-`ITRUCTION;AS BUILT <br />