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9613 BELMONT DR 2018-01-02 MF Import
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9613
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9613 BELMONT DR 2018-01-02 MF Import
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Last modified
1/19/2022 10:19:21 AM
Creation date
1/23/2017 12:27:30 PM
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Template:
Address Document
Street Name
BELMONT DR
Street Number
9613
Imported From Microfiche
Yes
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APPLICATION FO'l RIGHT-OF-WAY USE PERMIT <br />everetl <br />10099 <br />CITY ENGINEERS 7` 1 _� I <br />EVERETT, WASHINLGITON / p L� n ` PE';MIT N0. �r <br />The Undersigned �(, -JA e /b� /.A/ <br />Hereby applies for permission to iCbA4_Cr-,P&& T PToe�IIJ <br />T <br />At the following location^ <br />(Work to be done) <br />E <br />�T <br />Adse,0QLE <br />To <br />DRIVEWAY SECTION <br />NO SCALE <br />1 441.0 <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT, 259.8811 <br />24 HOURS BEFORE CONSTRUCTION <br />Date <br />n , <br />C;'i0N L'a'(Ck l=ti <br />Remarks p, q !r} tl IF' - <br />Note: Original to Customer <br />1 Copy to File 10099 <br />1 Copy to Inspector <br />M <br />NEW r,6NGPETE <br />DR/VFWRY / <br />*1=A1. J "rylo SIDE WNLK <br />CURB eVGOTTE2S <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of Installa- <br />tion and maintenance of the improvement hereto <br />applie and further agrees to remove same upon <br />no . e fr the City and eplace public roperty <br />ma e t re —y-y� <br />N <br />Address 110 <br />�CV u Date ,4 <br />�— �_ <br />7� <br />/ Fee - ' <br />all ' Dept. Approvals <br />Enginier,� f H A <br />W- <br />Street_kqAff <br />�_ <br />CrramTrafrfie&Z' <br />V, ' <br />Approved by <br />ate A Prov <br />
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