Laserfiche WebLink
eVefe„ APpLICATION FOR RIGHT-OF-WAY USE PER IT <br /> � TYPe or print cleerly with ir.4 <br /> PRESS HARD - YOU AR[ MAKING COPIES <br /> � �. <br /> PUBIIC WORKS PERMIT NO. <br /> EVERET7,WASHINGTON � <br /> APPIICANT (UNDERSIGNED) AND FIiiM REPRESENTED, IF ANY: <br /> _�/j/II�CJ!/GL� � - ' <br /> �/L ;'- ,�`-.�',�'Iu� 17 - 2a �culo�� <br /> HEREBY APPLIES i�OR PERMISSION TO <br /> �'U3 Ti2�C�T ✓9�r.o <br /> � - - <br /> /��ZuI�/Y�h' /� l�F� LC/2r'i� <br /> AT THE FOLLOWING LOCATION <br /> 6 6 Qs C--��ni�vcsc�,a d. � , <br /> DRAWING (WORK TO BE DONE) OR THREE PLA ATTACHED: <br /> �� 3 K �, <br /> � � <br /> �� � <br /> � C� <br /> F'::::� �,�.,�i� <br /> c. �� ,�:_;.7r <br /> F�.:IYuks C:pt <br /> � <br /> — •..•r <br /> MAR l. 3� �� <br /> G��"-�✓�c�rs d�,0 <br /> ORIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS {.------ �� <br /> I <br /> COPY OF THIS APPLICATION TO BE POSTED I" LIP <br /> ON JOBSITE. 30" <br /> 30'� � <br /> CALL P�R INSPECTION 259-881 1 <br /> 24 HOURS BEFORE CONSTRUCTION 7ha unEerSignetl Owner he�eby agrees lo�o�d entl seve hermless <br /> the Cily ot Everett Irom nny and all claims lor tlemeges. cosls, <br /> eRpenses.or causes ol eclion ihet may erise becauso ol installal�on <br /> and maintenanCe oi Ihe �mprovemeM or othcr rignl-ol-way use <br /> �erelo apphed lor an0 luriher agrces Io remove same upon noime <br /> Irom Ihe Cily antl to �eplace pu�hc pro0erty tlamagetl Iheieby <br /> DEPARTMENT APPROVALS <br /> SEWER COMMUNiG1TiON5 <br /> _�_�J / <br /> DRAINAGE tRA�F�� � i .r�,�G-+f-f-G�� <br /> SIGNRIURE OF RCPLIGANT <br /> WATER PLANNING � <br /> ��, tSvv .30(r� <br /> aooaess y�J +� <br /> SIREET (�'J�O / <br /> ��� ziv <br /> citr <br /> AFPFOVEOFORCUNSTRUCTION �ATE .3SS- ��.35 ��rEqNArE <br /> TELEPMONENUMOEA <br /> � j 7 <br /> AFPROVEO AS CONSTRUCTED <br /> DATE OAIE <br /> fEE ��78 <br /> CUSTOMER <br />