Laserfiche WebLink
tvcrett <br /> APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> .e �. so218 <br /> CITY ENGINEERS <br /> EVERETT,WASEIINGTON PERMITNO. �� ^ ��� ' <br /> The Undersi�ned _ C��(a iV/.(i �/D�G/� $ �!/� <br /> Hereby applies for permission to___�'Q1L,LT/U�� � -�3 � �G.0 � � f"� G!/ <br /> At the followin� location .� Q� / S /E UJ ��, LOT �fZ � <br /> SKETCH <br /> (Work to be Jone) <br /> //� <br /> No _c,Gq1.4. <br /> � � I <br /> z80I � V <br /> �nsr�Nu i _. G ;�_., uEw z3' a/w <br /> C�Itg � G�UitEG <br /> - ,;, , , � : <br /> ; I���/ii, ja. 25 <br /> �/ � <br /> � <br /> _ ►-n R s� � T v � � � � n� <br /> � <br /> /Uo T�; IUAT�',P .SEL'di�E Ta �' LvC'.Q T�D �Fr�,eE <br /> C'oN.si lZdG'rioiv oF ,G72iv��u�9 y <br /> �RIVEWAY SECTION The undersigned ownen c�re6y agrees to hold and � <br /> _ N� S��E save harmless the City of Everelt from any and all <br /> f'- 2 � cg�l , claims for dama9e;that may arise because of installa- <br /> t" up � tion and maintenance of the improvement hereto <br /> � 3p•� � ��. _ �30., � appiied (or and further agrees to remove same upon � <br /> �`–'7'– —•'I notice (rom the City and to replace public properry <br /> I dam ther y. <br /> � �!�W N D� ignawre o�pplican , <br /> /7-75 ' �U <br /> CO?Y OF THIS APPLICATION TO � 6 Address <br /> BE POSTED ON JOBSITE. .�5�3– a S OQ <br /> � CALL ENGINEERING DEPT. 259-8811 Telephone Number <br /> � /� - � _ 7 <br /> , �� �inuRs o�r-oRe cor�sT�ucriori�� oa1e __ <br /> CHECK LIST Pe��� �O � � � <br /> Water Valve i <br /> Drainage / �ep . Ap roVal, <br /> ' Curb&Gutter i Engine s � y�"�^' �c–���' <br /> Sidewalk `� <br /> >� Warer _ p.� � <br /> - Streci A�'.' <br /> Communications -� <w _ 6-�K.�y_ <br /> Inspector's Signature / <br /> Traftic , 75 <br /> Planning � '� � � F S' . <br /> at�e— <br /> Remarks <br /> . Note: Original to Customer � <br /> i ca�Y�o F�i� � n� � 8 <br /> 1 co co �ne ector <br /> PY P Appr d� �� <br /> 6 - 2 3. 7,- <br /> Qate Approved <br />