Laserfiche WebLink
" APPLICATION FOR RIGHT-0E-WAY USE PERMIT <br /> evcren <br /> � 10415 y r��' I��, <br /> �(�,('� � <br /> CITY ENGINEERS � ` � <br /> EVERETT,WASHINGTON PERMITNO. �/�—=J4'" ' <br /> �,.i''lJ <br /> The Undersigned� /'/�"�-��,�F�(./ �j L%`� �� ' <br /> He�eby applies tor pertnission to �� �n .cr*" � .v�¢�G.. r->-f — -� ._.-�C'jC'�� �.J��.,tL/ _ <br /> __ ^'", � �- <br /> At the totlowing location � � C_ c a_. � l - <br /> SKETCH <br /> (Work to be done� � <br /> i <br /> � �I <br /> l' ,1�s�, "5'i,�Evi✓�>' .. <br /> ''IFF�=L.�'NG :i►; � <br /> ' n <br /> � <br /> � � , .� �'�� <br /> ` ✓���/ �° � ���� <br /> IT A,/i��`K•.� � Y � 9II � � <br /> � �.� 2�L`� `�c� � � I <br /> � _ — ! �, �l I � i, -i- <br /> � NorF� . �- i' � ' � � �, <br /> •�Y 34"Pc�,iwoov r.w�.E,c � �' � --I io• �--_- — _. <br /> ��4F�o!-L�iNG d (. '-n/� �) <.�-f? ' - � <br /> i P/�T�GT/0�1.� �, pF s/,'V' �Y_:;'j-=�;�r` ',. <br /> � ,'�` l ' !� ` <br /> ���� � � �p�S�Wa�o r'o <br /> G P�orEcr S,�aEw.� <br /> 4 <br /> I II <br /> I <br />� <br /> yEl^✓i7T f) VE . <br /> � ORIVEWnY SECTION The undersigned owner hereby agrees to hold and <br /> '� � � NO Sca�E , save harmless the City of Everatt from any and all <br />� - � �-�`-�-. � claims tor damages that may arise because o1 installa� <br /> � � �i^ L��-�.--� ��,q tion and mair,tenance of the improvement hereto <br /> � I 30" ' �- � 30" � applied for and further agrees tc remuve same upon <br /> � � �`-'�`-� � ' i�' notice from the City and to replace pvblir property <br /> � .U� damaged thereby. � <br /> I r�`.�. } , ��1U -�„�..� �.,��__ , <br /> � Signatur/e of Applicant <br /> ' jl�!' �f/ /�"7 �� �,Q /n c-��__ <br /> '� ' COPY OF THIS APPLICATION TO U �] ' Address — <br /> � �• BE POSTED ON JOBSITE. Z 3-7 _l/t-; <br /> � � � CALL ENGINFERING DEPT. 259-8811 Telephone Number <br /> - . � ��� —�7�`_ . <br /> , � 2�1 i'Ul'HS B[PORE f.ONSTRUCTION . Date <br /> � - --_.. . . .---�-� — `J'Lt% . ' '—�: <br /> .' CHECK LIST Fce � � <br /> Water Valve - <br /> � e p�r �yals <br /> . ' Drainage _ <br /> • � � Curb&Guttcr Engin � � <br /> Sidewalk 4�6; 1 Water��` ��'ef i.r�y, ,p R� - 3-�G-76 <br />. � ' �. -��--�.... . Street— 'L�.-v �'�, <br /> , � z� � � � <br /> _ Communicatioqs� i <br />. � Inspector'sSignature Traffic ' <br /> ., , �` . ..� _ Planning. -, / i � . <br /> at�— �'^ - Sc�uev - /�/� �L <br /> OfU F �� <br /> , _ � ..'' t�"' f� l.�t`l(-tG�� <br /> � Remarks � ���J <br /> Note: Original to Customer -- ��. <br /> � .. 1 Copy to File ��4�5 <br /> 1 Copy to Inspector Approved b ��� . <br /> Date A'�proved <br /> \ <br />