Laserfiche WebLink
APPI.ICATiON FOR RIGHT-OF-WAY USE RERMIT <br /> � crcrett 10253 <br /> � <br /> j ; ,3 <br /> CITY� ENGINEERS �_� <br /> EVERETT,WASHINGTON PERMITNO. �-� � <br /> The Undersigned ���-1�� 1 �' r1'�T L �L <br /> Hereby ayplies for pertnission to U S� � 1��r-�l�.fh� il - �"� �"��� �� 1 �'�r � rj���� <br /> ,=on, DIS PL R�l i ;, i-vs r� <br /> At the following Iocation_. �L7�� �G�I� <br /> LOTS 1, �. � e'4 <br /> SiCETCH <br /> (Work to be done) ,�v � <br /> �nr� riN�: �s' siu".u�r�e � <br /> I UJ ID TN OF 51�c�I/AtlC <br /> 4'x5' /�R£� IUiLL BE INCRt �S�D <br /> 1`R0��1 16' rJ 25 ' <br /> � UNAFI� CI�D I/`!l'�. <br /> � � <br /> � � str�vice sr�a� <br /> �r�r � srav� p' I <br /> l�s — - - - - - - r�_, � �fcor�r� roR cr�►�rs <br /> ON WHE�LS <br /> � 70 ! ; � <br /> a � <br /> � 7,3- <br /> _ ❑ TE'LEI�NUN�' 6UOTH <br /> ° �� PUUIt'R 1'�L� s-. rlf{E <br /> ¢'xg" RR�i� I `Lrj �LAR�i <br /> _ ,;IOCI�t/q�K � J <br /> . __ I � <br /> � U <br /> . — � ' <br /> , <br /> , � � <br /> Vc � f_ 1 J ' uot�: <br /> LlC+�'NS� Fr_�' OF 7.50 <br /> � r�evUiR £i) iu C't�7�1;� vFr: � <br /> � DRrvEwAY SECTION he undersigned owner hereby agrees m hold and <br /> NO SCA ' save harmless the City of Everett irom any and ail <br /> � --� ciaims tor damages that may arise because of installa� . <br /> i•� [ion and maintenance of the improvement hereto <br /> applied for and further agrees to remove same upon <br /> 30�__ 30 <br /> �- i --�—� notice from the Ciry and to replace public property <br /> damaged thereby. '� <br /> $igna[ure of Applicant ' <br /> DU,IN. L� Y L6�J �tif. <br /> � L'OPY OF THIS APPLICA1lON TO c� Address � <br /> I BE POSTED ON JOBSITE. V-4-75 <br /> '. CALL ENGRJEERING DEPT. 25D�9811 <br /> Telephone Number <br /> � ri��ur��s �r_r-o�3r- coNSTrtucnorv ��,tJ�/1�LL oe� <br /> _ �vo F�,� <br /> CHECK LIST Fee <br /> Water ValVe ���N�/ ���� �, <br /> Drainage " t. A�pfoV815 � <br /> Curb&Gutter �(/ �J� ��jvf�-� ���Enginee s `� . p S , <br /> Sidewalk 7 � `� <br /> Water � _9, ,s � -' <br /> - -.:.-.. h .L r;. �'/Q Street � <br /> 1 r.e-� Iy���-L ' ommunicationse! -�• +�> • �-�-7�"" � <br /> Inspector'sSigna[ure - �g/s_� �'� e, <br /> ;�_�..r �-- �_ Traffic ��r,:_�. , _ ✓ � <br /> Planning /r�`�� " il.. <br /> ate ��+ �-rv.u.% ' ! <br /> Remarks � <br /> Note: Original to Cusromer �! <br /> , �aPYtaF��e , 10?53 ' <br /> 1 Copy to Inspector Approved by '� <br /> Date Approved <br />