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t <br />® WATER TRANSMISSION LINE <br />i RIGHT-OF-WAY USE PERMIT <br />APPLICATION <br />CITY OF EVERETT PUBLIC WORKS <br />3200 CEDAR STREET, EVERETT, WA <br />98201 <br />(P) 425-257-8827 I FAX 425-257-8882 I (E) TLROW@everettwa.gov I www.everettwa. ov <br />PROJECT SITE INFORMATION <br />F ADDRESS or APPROXIMATE LOCATION: 2422 Grand Ave. #C <br />TION OF WORK: We will break access in city sidewalk and excavate proposed location to expose <br />sewer line. We will spot repair approx 4 ' <br />repaired, <br />section of sewer line, once line has been <br />CHECK ALL THAT APPLY: []Proposed Road/Driveway Crossing ©Proposed Utilities in ROW CEarthwork (cut and fill) <br />iOSewer, Septic & Drain Lines Water/Irrigation ❑Fencing, Landscaping, Tree Removal ❑Electricity, Gas, Communication <br />.30ther (provide details): <br />CONTACT INFORMATION <br />NAME: Michael Mulvihill <br />MAILING ADDRESS: ST�ET2422 Grand Avenue #C <br />crry Everett STATE WA ZIP98201 <br />OWNER PHONE: 2068546289 1OWNER EMAIL: mulvihillsm@gmail.Com <br />:Johnny Burch <br />LING ADDRESS: STREE12401 SW Alaska St <br />CITY Seattle <br />STATE WA <br />LIP98106 <br />ONTRACTOR PHONE: 2068519355 (APPLICANT/CONTRACTOR EMAIL:johnny@beesplumbingandheating.com <br />CONTACT: O OWNER <br />ACT NAME: <br />Sam Jr <br />0 APPLICANT/CONTRACTOR 0 OTHER (Architect, Engineer, Etc.) <br />CONTACT PHONE:512 945 1473 <br />CONTACT EMAIL:johnny@beesplumbinqandheatinq.com <br />Attach one copy of plans for the proposed work showing: <br />• Property lines <br />• Outline and dimension all existing and proposed structures and roadways/drives in the Rights of Way <br />• Existing utilities in the Right of Way <br />• Any proposed grade changed in the Right of Way <br />For Office Use Only: <br />OPre-Approval Meeting <br />❑ Pre -Construction Meeting <br />Form: 05.07.2021 <br />