Laserfiche WebLink
laPPLICATION FOR RIGHT-OF-WAV USE PENMIT <br /> evcrcfl 1 O L C � <br /> � 1 C1 <br /> GTY ENGINEERS " .' <br /> fVERETT,WASHINGTON PERMIT N0. _.___ ____ <br /> The Unde�signed ��_� '� ��� �_- - -- ` ' � ' ' 7 - <br /> Hereby aPplies for permissinn to�j�, i� ��:� ��� /� ) {'�1�� �L � L�:I � � � /�"� � __ <br /> At the tollowing location_ I4 U �7 L �'�� �� � L �� _ ___ __ _ <br /> ` ./.— -_. - <br /> — -- � --�-'- -- -- --- ---- <br /> SKETCH � � <br /> (Work to be di r.e! I ` <br /> I <br /> i <br /> � , - I <br /> t ` <br /> C . ' 'L ' � �, -- I <br /> •_.�'-- --� i..__ .___ . ..�..��_ <br /> �� � 1 <br /> � � � ' --__ <br /> I i I <br /> N- �ll /a� 1'Hi-IL 7 ---- — { \ t��\��, I-�t)6 <br /> �, � �: <br /> D I� I Y? '+'/ �IV �'��`S - ---- -- <br /> � <br /> � I <br /> n � � <br /> � � �.__.....�._.�..�_ <br /> ; ;_ <br /> � <br /> �� � <br /> , <br /> - � `--�— ��,r i ; r��i r: c ur�� �� �: <br /> ��;� � ; u r r �_ r, <br /> � <br /> URWFWAY SECTION I The undersigned owner he�ehy agrees tu hold and <br /> NO SCaLE I � 1, save harmless the Ciry of Everett from any cnA all <br /> �`--� - � - Zy ' J � - claims tor damages that may erise because of installa� <br /> ���„ ��P =� � tion and main!enance of ihe improvement hereto <br /> 1 I applieA tor and fur[her agre s to remove same upon <br /> �JO+. ..T_���--_�30��1 .- <br /> notite from the Ciry an t6 rep yublic property <br /> ,dar�ged there /' � <br /> � _�p �GJs'v-- �1-��JE_Li/Cs� <br /> �- 5(gnat reo A ice t /,- <br /> ri/F '� �` <br /> I��JI�I. li � L 'J1/ �r. q�QL �-�-_ .�.�.� <br /> � iPv OP '�HIS APPLICATIGN Tl� <br /> . �'OSTED ON JOBSITE. � " '� � ���/ Z�Z- ���_ <br /> �I L ENGINE[RIN(1 D[PT. 7Fi!�'. Telephone N mber <br /> �J3-7� --- --- <br /> . � .;�ii: Dr ����nf inr;�.i �., ., � ir Date <br /> � . <br /> -- _ /,:_ ,�"_: _ _��- �' -L-�%'f" <br /> �CHECK LIST Fee� <br /> Water Velve i t. f�pproval5 <br /> Dramage � c <br /> Curb&Gut[er / �4 �. ; �. Engineer f�,i��' � C''-'/�� - I f-. <br /> ..----- '�-� J- -- -. <br /> Sidewalk . . Water� �ivi�,�_J� T�' <br /> , / �j � .( � -��.=�--��_ �. -- <br /> r T affcumcntion t M1--� u �: ' � <br /> InsPec�oi'S igneture � � � . Veet ' � �� , 3 < <br /> , . , � . Plennin� �l-/' <br /> - � i <br /> - ----- -�---- � -- ---- <br /> 6atc -- <br /> 1 - -_ <br /> .� _—_ �___ _.. __-_-- -_ <br /> Remarks <br /> Nnte�. Onyu�al to Customer <br /> , ��,,,� �� F,�� 10 �61 ----- - <br /> 1 CoPy �q InsPcr.toi Al��ov�rd�b,r . . . . '_! • ;�. _ <br /> .�___rL -_ - - <br /> Date hj�Proved <br />