Laserfiche WebLink
:y� . <br /> `� + evv.ren APP�-�CATIO�' FOR RIGHT-�)F-WAY USE PERMIT ' <br /> 10955 i <br /> � � <br /> CITY EIJGINEERS � 7/ II <br /> EVEF.ETI', WASHINGTON PERMIT N0. ` � j�S <br /> � <br /> �� <br /> ' The Undersigned_��1,L _,J r7i,�- �.___ <br /> � <br /> Heraby applies for per,ni_;ion to � �� � ,.� i <br /> ��`_l�if_,f�.iG /� 21r� ( oiiC � ' U�i.�/ <br /> i --- <br /> A1 the following Iocation��fL{Z" y` �`�� ti� ��,z I <br /> SKETCH — __ <br /> , (Work to be aone) 'i <br /> s V c �! /�G�/Yr t� � <br /> � <br /> � <br /> I <br /> � <br /> ' I <br /> 1 <br /> ' � <br /> ' I <br /> i <br /> I <br /> i I <br /> l I <br /> i � <br /> � I <br /> � <br /> ' � <br /> ' � <br /> I ' <br /> � DRrvEWav SECT�ON ��he undersigned owner hereby agrees to hold and � <br /> � NO ScnLE save harmless the Ciry of Everett frum any and all I <br /> � � _ -� claims for damages that may arise because of installa� ' <br /> '�. i�" Ua tion rmd maintenance of the improvement hereto ' <br /> iL _ �30,� � � appliad or and urther agrees to remove same upon <br /> � I� �� �� -- —•1 not�ce fr m tl City d to replace public property I <br /> �. dainage ther I>y. :� i <br /> �' _ .�, <br /> ; S�gnature of Appl�cadt ' <br /> �� COPY 01= THIS APPLICATION TO � ddress n �� /l � �'�' '`�'J� �� I <br /> I BE PC�S�ED ON JOBSITE. I� j �?� ��;�/ y y L ; <br /> �. CALLENGIME[RWGDEPT. 259�RF311 TelephoneNurpber,.) i <br /> / ? i <br /> �4 I-IOUFl; 6EFORF CONSTRUCTb]N� Date - I <br /> '/Z .S� <br /> � i CHECK LIST Fce I <br /> Wa;ar Val��e ' <br /> Draina9e Dept. Appr vals <br /> Curb&Gutter Engineers� .a' . <br /> Sidewalk � <br /> 4Vatei <br /> Street <br /> , Inspector's Signa[ure <br /> Communications �� <br /> � Traffic '� <br /> Planning <br /> �a ie — <br /> �. R�.marks <br /> Note: Original to Customcr _ <br /> , �oPY to F��� 10 9 5 5 ' <br /> . i Copy to Inspecmr Approved 6y � <br /> Date Approved � <br /> —�c:� <br />