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4902 FOREST DR 2016-01-01 MF Import
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4902 FOREST DR 2016-01-01 MF Import
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Last modified
2/11/2017 10:15:43 AM
Creation date
2/11/2017 10:15:33 AM
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Template:
Address Document
Street Name
FOREST DR
Street Number
4902
Imported From Microfiche
Yes
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.v% .//�, , ... <br /> everell <br /> � APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or print cleady with ink <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBIIC WOfiKS <br /> EVERETT,WASHINGTON PERMIT NO. �� - �`'� 1-- <br /> APPLICANT(UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: C-����� ��� 7 ± ' I'I C � '-( c� 1 C <br /> C <br /> HEREBY APPLIES FOR PERMISSION TO ��S L (: � I i T I YV L J.�f- � V �' \ <br /> AT THE FOLLOWING LOCATION �-� - �l � G_ '� �� E' • ���� ��)` — <br /> DRAWING (WORK TO BE DONE) OP. THREE PLANS ATTACHED: <br /> b�� <br /> �� � . ����� <br /> �-- ,�, <br /> � y-� �, . <br /> ��t <br /> � <br /> �r�.,I * �. <br /> �q�F1.`� �O�a ?o <br /> � �� / U/�pd,L �� <br /> No � ��m�D'cL <br /> f <br /> .�j <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS � --+{ <br /> � COPY OF THIS APPI.ICATION TO BE POSTED i" ��p <br /> ON JOBSITE. I 30'+ , � -.r30��� <br /> ; CALL FOR INSPECTIOH➢ 259-881 1 r __ <br /> 24 HOURS BEFORE CONSTRUCTION ��� <br /> ---;::-�. <br /> The untlersignetl owner hereby a9rees lo holtl end seve harmless " <br /> � <br /> Ihe City ol Everett irom any and all claims or amages, cos s. <br /> expen5e5,or Causes ol action Iha�may arise beCeUSe ol Installation <br /> an0 mamlenance ol ihe improvement or olher ngh4ol-way use <br /> hereto apObed lor and lunher a9rees lo remove same upon nobce <br /> Irom Ihe City and to replace pubhc propetly aamagetl ihereby. <br /> DEPARTMENT APPROVALS <br /> .I r_ <br /> i^ r � <br /> i .;� � <br /> �� �, � � .' ... " I <br /> SEWER "�. j COMMUNICATIONS <br /> l_-. <br /> ; <br /> OR4INAGE �}��'�,� i iRAFFlC ' <br /> ' � <br /> i _ � <br /> WATER �o............._. . -. . PLAr1Nl�{�. SIGNATUREOFAPPLICANT <br /> � TT3;'I�'�� -�,;.i r , .., yc a � _ <br /> STREET i IjOU <:ri:Oi'i . �:.�� qpORE55 <br /> �.z ��.!_ ., � �� �� T ��� `ig�o3 <br /> , t y/Zo i I <br /> APPROV� CONSTRU TION Onr , i� ,c} — ��(1 __ <br /> LEPMONE NUM�ER ALTERNhi'c <br /> N - ) �- � 1 -- <br /> APPROVBD��`_ CONSiRUCT[D t�-*' naiE <br />
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