Laserfiche WebLink
I F• <br /> � <br /> I , er�C <br /> �� :AppLI�A�'ION FOR RIGHT-OF-WAY USE PER!►/IIT <br /> Type or print clearly with ink <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS / <br /> EVERETT,WASHINGTON PERMIT NO. 4.�.= <br /> � � ���J �-{/.� � <br /> / � , , <br /> APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY:�`���� - " "�r <br /> l�J��, , <br /> �, <br /> HERE6Y APPLIES FOR PERMISSION TO <br /> AT THE FOLLOWING LOCATION �N I � L�I�I - <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> ' �� �� �,��� . ���� � <br /> � � �. <br /> / / � �,,.� �-,�v1-j.:L(�L,'�f'7�( <br /> ���" J <br /> � <br /> I <br /> i <br /> i <br /> i <br /> , �i <br /> J � <br /> 1i <br /> , , <br /> ;� . <br /> i I <br /> J I <br /> DRIVEWAY SECTION i <br /> PERMIT IS VALID FOR 60 DAYS l�- -� � <br /> I <br /> COPY OF THIS APPLICATIQN TO BE POSTED �- ; i" i iP <br /> �' ON JOBSITE. 30" _�_30" <br /> � CALL FO�i IN�PECTION 259-t387 1 <br /> I 24 HOURS BEFORE CONSTRUCTION The undersignetl owner hereby agrees to hold antl save�armless <br /> ihe Ciry ol Everett Irom any antl all claims lor tlamages. costs. <br /> ; e�penses.or causes o�aclion that may arise because ot installation <br /> and maintenance ol ihe improvemeni or other nghi-ol-way use <br /> M1ereto applied lor�ntl lurlher agrees to removc same upon nohce � <br /> irom Ihe Ciiy ana Io replace pub6c property tlamagetl Ihereby. I <br /> DEPARTMENT APPROVALS <br /> SE14ER LOMMUNiCPilONS <br /> � 1 � <br /> DRAINAGE TPAFFlC . .I L_ . /" I <br /> .-. t�" .-/, / . <br /> Y <br /> �� � ' ��qNNING SIGNA��PLICANT / <br /> WAT[R .�1 �'�i� 1. '` � . � (� <br /> �n} �.��1 �.1 ' . . <br /> `'��� �' noon ss. /`�'�.. ` <br /> SIREET�.�i,�� , .� '.� ( ����\ ) <br /> ,'`�y . '�� ��..� CITY � ZIP <br /> � � V ��� � �IZ.� <br /> R VED FOF(.ON, RU ON ATE � - <br /> - � 'l4� � ��• �7 iELEPHON NIJM1 ER NIiERNAiE <br /> � � ' � `'`j�)�- -7 � �' <br /> ,,. <br /> <: ` / - <br /> PPROVED AS CONS,R �CTcL o^'E �A'� <br /> . � corisrr�ucrion!r�s r,�iu_r ��r ,s�a I <br />