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1004 LOMBARD AVE 2016-01-01 MF Import
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1004 LOMBARD AVE 2016-01-01 MF Import
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Last modified
2/17/2017 2:57:23 PM
Creation date
2/17/2017 2:57:07 PM
Metadata
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Template:
Address Document
Street Name
LOMBARD AVE
Street Number
1004
Imported From Microfiche
Yes
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, ; <br /> APFLICATIOAI FOR RIGHT•OF-WAY USE PERMIT <br /> everetl 1 0 1 2 6 <br /> � <br /> C!TY ENGINEERS 7�— /� <br /> EVERETT, WASHINGTON PERMIT NO. � <br /> irieUndersiqned ��)�� CJ/l/ST�//C'T/Of�/ <br /> . <br /> Herehy applies for permission to .S7— C .G-L /9 <br /> �:v� Gqtise,�,o.� a�i ��rs- p�,Pa/'�,PTY <br /> At the following location �D�'J � U�[�`/�Q <br /> SKETCH <br /> (Work to be done) � <br /> �I <br /> �� <br /> � NEW <br /> l.-XISTIN6 �F�= �uoon��wv/( } ' <br /> �ft�WALK S/DEWAL�Y w <br /> J <br /> J <br /> � /aa4 � <br /> � <br /> � <br /> � <br /> � � f?e�rir �7ro,Eer! �/ <br /> Q y\ �v/J cct�poiny5 ��"Z+�`G'. � <br /> J LANDSL�f�l7/N6 �owrr, o� � � <br /> ,1�� .,; �/L%�I,—• <br /> ��-- <br /> � <br /> 20' 27�z — �iw �N�W Ctl/�.'',PETE <br /> W <br /> , , ' /0 Ty ST. ' <br /> � � <br /> ; <br /> Nd SLYaLE RIVEWaY SEC7i0N The undersigned owncr hereby agrees to hold and <br /> . NG scALE save h: '_ss the Ciry of Everett from any and all <br /> 2( ' � claims for..amages tha[may arise because of installa- <br /> ' � /�.,�`� {' tion and maintenance of the improvement here[o � <br /> �I�� LIP � �� �-� <br /> applied for and further a9rees to remove same upon <br /> �3� I . � / � I 30� I notice from the Ciry and to replace public property <br /> --�T—�Y�--�1"—�1 . <br /> 1 I 1 damaged thereb . <br /> � �/ /1/r/('r 5 �uIO UE' :_'. /�C. � ,. I tCJHC1"S r;rn,s:. c /3/�� .LC7' <br /> q�� � � 0�(� Signa reo�Applicany <br /> -- � ��,,1�( : r, ��.� 23c S �J�� ST <br /> �COPY OF THIS APPLICATION TO i Address�. <br /> 6E POSTED ON JOf3SITE. ��f/F� T ��N/ <br /> Telephone Number <br /> � C;AL� ENGINEERING DEPT. 253-8:?1 7 � `�.SZ—�8Z �o <br /> 24 H�7Uftb L'Ef�ORE CONSTRUC710ta ' Date � <br /> �- .f Z -/.3- 75 <br /> CHF.CK LIST �(�1 N F�e /V, D /.��Q a -/5�-7�' <br /> water valve ��/y,7� ept. Approvals <br /> Drainage Z ,_[_� 2,z� <br /> Curh &Gutter �()CR�Qir bry���eK f� 'r Engineers i "�""'� 4 . � <br /> Sidewalk GUY�i 41 'JO�N�S '+�Water d _ <br /> � Sko�K• 'p� �treet � ` . <br /> �VIC1K K� f \ � l� a,.ev . z_. zo <br /> Gpmm���ICdClO 5 <br /> Inspector'sSignature Traffic ' � � � <br /> � ��S _ �S- Plannin� �' ���75� <br /> a[e <br /> Remarks <br /> Note: Original to Customer <br /> 1 Copy [o File � n�?6 <br /> t Copy to Inspector � Approved by . 'J :�i�wr� 4 <br /> Date Approved 'Z � �L f� � <br />
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