Laserfiche WebLink
-- --� ---T- <br />, ,�- <br />i�vcrelt I ' <br />I <br />� � 1� <br />CITY EN�INEES'+S <br />EVEIiET7, W,1SHING70N <br />APPLICATION PqR RIGHT-OF-�'!/�Y VSE PE}1M1T '� 1 ��? <br />PENAIITNU._Z8_` / 7 <br />The Undersi9ncA ---- --- -- ----- -- '----- <br />Hercby a{tplics for permission to _ L d �t 5�� 25 � Cn �9 C, ���� 'i"r C a r� �v� ✓� <br />At the followin� lowtion _ 3 G 6� T!' � ci�`� �Li c' _____ . <br />— ✓ --- <br />SKE TC H ------- -- � - ----- — <br />��Vor6 lo br donc) <br />DNWEWAY SECTION <br />NO SCALE <br />r-_ __- ----- � <br />�_ �t_iv � <br />�,.3��� � 1 . .. . . _ . _�30,� <br />� <br />---__------ - --- <br />COPY OF THIS APPUCATION TO <br />I BE POSTED ON JOBSITE. <br />� CALL ENGINFERING DEPT. 259�8811 <br />24 HOURS J[FORE CONSTRUCTION <br />I---- -- — <br />CHECK LIST <br />Wa�nr Valve <br />Draina9e <br />Cur6 & Guttcr <br />Side���alk � <br />Inspector's Si9namre <br />-Date - -- <br />- - - - - - — -- <br />Rcn,:uks <br />1�.i�3 <br />CUSTOMER <br />Tlie undc�signed owncr hereby agrecs to hold and <br />save haimless ihc City of Everetl from any and all <br />claims lor damages that may arise because of inrialla� <br />tion anJ maintenance of thr improvement hcreto <br />applicA for anA further agrees tn rcmovo same upon <br />notice fmm the Cily and to repincr, public properry <br />damaged Ihereby, <br />. i�'_.. _. �_..: �-,>,�'.s..-�_.�. .v.-_,:.. <br />• --�r� --S'_`-- — -- <br />Siynature of Applicant <br />� =J.//� —_�:'-�y,..u--r �4-�. p <br />Adcl�russ — <br />� 'l�_J� " % � �i C�i <br />_ <_ <br />Telephone Number 1 <br />_ "___"'_�1_� ` _ _ <br />Datc <br />—..—__ .—_.-- --� ---- <br />Fce <br />Dept. Approvals <br />Communications <br />PI <br />Approved by <br />D�tc Approved � <br />