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4918 ELM ST 2016-01-01 MF Import
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4918 ELM ST 2016-01-01 MF Import
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Last modified
2/12/2017 7:28:45 AM
Creation date
2/12/2017 7:28:25 AM
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Template:
Address Document
Street Name
ELM ST
Street Number
4918
Imported From Microfiche
Yes
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l: � 7S <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT ��31 H `"� "�` <br /> ev, retl . �.�� <br /> > <br /> �� .n . <br /> CITY C G EERS � y�. <br /> EVEREi ,bVASHINGTON PERMITNO. �� � � <br /> The Undersigned_��,��1 /�'1 �/ 1/ I'+� � <br /> Hereby applies for permission to f n N S TR•i � > /1 7 ti' ro i �F—f /���n.' <br /> A[ the foilowing location % i/,; )-' l, �.;.i <br /> SKETCH <br /> (lVork to be done) • <br /> ✓ �V <br /> F ���- J <br /> A <br /> ,t��� S TR E,�7J_._�---__= <br /> �y,oG <br /> � ' � ; <br /> ,�J ' I <br /> 5�9!y <br /> CA,..N <br /> � 1 <br /> � 0 <br /> 0 <br /> N <br /> � <br /> oG � <br /> DRIVEwAY SECTION � The undersigned owner hereby agrees to hoid and <br /> {���NO SCALE save harmless the City of Everett from any and all <br /> I claims for damages that may arise because of installa- <br /> �� i�" Lia� tion and maintenance of the improvement here[o <br /> I 30" I � 30' I applied for and further agrees ro remove same upon <br /> � � �^t� notice from the Ciry and to replace public proper[y <br /> darr�,e�thereby�`�����r �- <br /> _�C!-L%,., !�/� <br /> Si nature of Applicant <br /> ;------- - - - /� ° /.3 �X `S�� .�/� $1=��-1 <br /> � ;;OPYO cTHI; APP�ICATlO� �o � A33��lSo <br /> 6E POST�D 0�J JCti51TE. J!' <br /> Telephone umber —' <br /> CALLENGINEERI�VGDEPT. 259-88T1 ���Q/' � � <br /> 23 HOUfiS dEFORE CONSTRUCTION ���� <br /> CHECK LIST Fee <br /> Water Valve Dept. Approvals <br /> Drainage <br /> Curb&Gutter Engineers <br /> Sidewalk <br /> � � Water <br /> ���, : Street <br /> � <br /> '� Inspec�Eor's5ignature ' - Communications <br /> Traffic <br /> y� — ��_� _ � f�� � Planning <br /> ate <br /> %�) � <br /> Hemarks - ,� � <br /> 11 �, 1g � <br /> Approved by <br /> ( CU570MHR Date APProved 3 <br /> i <br />
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