Laserfiche WebLink
�veretl <br />' Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />� Typa or prm� cleerly with mk <br />�� PRESS HARD - YOU ARe MAKING COPIES <br />PUBLIC WORHS � J/ � <br />EVERETT, WASHINGTON PEFiMIT NO._— <br />:PPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY:��"�'9N7�QS �1 • IuI (.�G H�ti"���r <br />HEREBV APPLIES FOR PEPMISSION TO UT�L /Z� ��iZ/�T� N� ���V �Z'V A� <br />AT THE FOLLOWING LOCATION �� � �� Y �L U� � <br />� DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />II � � -�i `� �C. l�'�,✓ /� <.fi`�'.�fi �'�� �����V <br />� V <br />PERMIT IS VALID FOR 60 DAVS <br />COPY OF TH!S APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTIGN 259-861 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />OFqINRGE <br />,�iTREEt <br />DEPARTMENT APPROVALS <br />COMMUNICRI IONS <br />TR�fFlC <br />P�ANNING <br />��, -i�-�� <br />AP R VED FOR CO TRIJ TION / OntE <br />' �� 9-�/ <br />PROVED A560N5 U TED Dn�E <br />DRIVEWAY SECTION <br />� � <br />� f I'� LIP <br />�.30-�-� -i-3°'� <br />ihe un0ersiqned owner horoby agrees lo �olA enC eave �ermless <br />I�e Cl�y ol Evereu Irom any end all cWims lor Uumages. wets. <br />expnnsm. or causes ol action I�aI mey ansu because ol mslnllation <br />and maintenance o� ihe improve�nent o� nlher nghl-ol�way use <br />M1treio dpp�ietl lo� and luriher npiees to remove same upon nobrn <br />bom Ihe Gly ana lo re0'�ce Ou�hc pioperiy damage� Ihe�eby. <br />/' I <br />�`--_�� 'a �/ � <br />SIGNr1iU�E � ` r1P'�.'�n�'1 <br />eo�� �,EveRLy f3LVD _ <br />A����E55 - <br />EVERtTi", I.JN, 9st�3_ _ <br />CITV LiP <br />3538781 -- <br />tELEI'MONE NLIMpE� ALIERNRIE <br />�- l�'SV <br />� CONST(�UCTION/AS DUILT ,E� - jy�g <br />