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127 DORN AVE 2016-01-01 MF Import
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127 DORN AVE 2016-01-01 MF Import
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Last modified
4/10/2017 10:27:34 PM
Creation date
2/12/2017 3:33:20 AM
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Template:
Address Document
Street Name
DORN AVE
Street Number
127
Imported From Microfiche
Yes
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�,,,�a,rN��,,,�. <br />� , <br />. � �%r-- <br />rrc�r�� <br />�� <br />ITY CNGiNEERS <br />VFF1'cTT, 1YASHINGTON <br />AI'PLICl�TION FOR RIGNT•OF�4'dnY LiSC P[.RMIT <br />109�� <br />rEnr,nTNa �f/ i�' <br />�'—•---- — <br />/ <br />hc Undcrsiyned _,J>_�F��� i� ��/�._�('.-�? J _ _ <br />lcrebv applics for pcnn�s:ion to ,(•'(1/1.� .�P ✓r.T �� C' � f� Gpl//�! _% L�/y�� _- <br />�� r <br />1t thc fo!lowin9location_[�� <br />KCTCH <br />l'Jark to he donc) <br />SEE !-}7TA�/fEo <br />�1�'� ' �-a Go�is7"h�` ��' <br />��U � /��/_" <br />i� <br />pRIVEW�Y SECTION <br />NO SCl+IE <br />� � <br />�" LIP <br />i-'�-�-�---- f -----i-3�-i <br />COPY OF THIS f�PPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259 8871 <br />24 HOURS BEFORE CONSTFiUCT10N <br />CHECK LIST <br />Water Vaive <br />Dramage <br />Curb & Guttcr <br />Sitlewalk <br />nspector't Signaturo <br />R.marks <br />Note: On9in�l to Customer • <br />1CopytoFilr �o�i�l <br />1 Copy to Inspcctor <br />The undersigned owner hereby agrees to hold and <br />sava harmless the City of Everett irom any anJ all <br />claims far dama9es that may arise because of installa� <br />tion and mrntenance of tha improvement hereto <br />applied for and lurther agrees to remova samu upon <br />, notice irom �tu�in and to replace public properry <br />dart.aged UyfC�iy� � <br />.�J <br />.......... /f�,/c.Yiu Gvi�. 7��75 <br />Telephone ou�c�h�1_y��.� <br />TS <br />DdtO <br />� <br />Fee /,� i ��- . <br />Dept. Approvals <br />Engineert.__ <br />Commun ication : <br />Plarning <br />ApproveJ by <br />Data Apyrovcd <br />
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