Laserfiche WebLink
; <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT ' <br /> everetl 10 9 81 ' �� <br /> e � <br /> CITY ENGINEERS � � <br /> ' EVERETT,WASHINGTON PERMITNO.' �7 ' <br /> , TheUndersignr.d r:�:,'./��a [_t> /C 7��,7 / li <br /> � Hereby applies for pertnission to �-r :1 'x. � ' - �_ "` 1 af � <br /> ��� Atthefallowinglxation �7/� l�/VGL.idMJ i-� ���.. ��, <br /> I <br /> SKETCH <br /> � (Work to be done) � <br /> �� `=Y.: I� 7'�` AC:i'I a� <br /> I <br /> � <br /> � <br /> I <br /> i <br /> � <br /> � ' <br /> I <br /> I <br /> � <br /> � • <br /> I <br /> � <br /> I � <br /> � <br /> i <br /> � DRIVEWQY SFCTION The undersigned owner hereby agrees to hold and j <br /> � NO SCaLE save harmle:s the City of Evcrett from any and all ; <br /> �, �— � claims tor damages that may arise because of installa- �� <br /> � i" LIP tion and maintenance of the improvement hereto ; <br /> applied for and further agrees to remove same upon � <br /> 30'+ _L30'y,� notice from the City and to replace public property <br /> i damap�reby. ,f D���? � I� <br /> i Signature of�ppli��r I <br /> � q-72S-'7� �J S?, S. 4J. ��' i <br /> ' CCPY OF THIS APPLICATION Ti) � Address <br /> � BE POSTED ON J06SIT-L .3 SS — �LZ./S � <br /> i I Teleph e Number ' <br /> � CALL ENGINGERING DEPI'. 259�8811I � �� _ �7 i <br /> � �24 HOURS BEFORE CQNSTRUCTION� . Date , <br /> I Ci-iECK LiST Fee �z � <br /> Water Valve ept. pprovals � <br /> I Orainage � � � � i <br /> Curb&Gutter � � Engineers ��i��-l.w r ' <br /> Sidewalk Water � <br /> Stree[ I <br /> Communications �� <br /> ' Inspector's Signature I <br /> Traffic <br /> Planning <br /> Date , <br /> Remarks - <br /> Note: Original to Customer . <br /> 1 Copy to File �0 9 g 1 <br /> � 7 Copy to Inspector Approved by �� <br /> � � Date Approved <br />