Laserfiche WebLink
.� , ___ - <br />evere8 <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMfT <br />vType or print clearly wrth ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS � � // S � <br />EVERETT, WASHINGTON PERMIT NO. � <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: O � �CJ4l�.�f ,�,�st/ � <br />HEREBY APPLIES FOR PERMISSION TO CO N S�.YLlC/ �O , f%S�y4 /� <br />dr�uF�a y <br />AT THE FOLLON�ING LOCATION �� �( IY —�3 L <br />DRAWING (WORK TO BE UONE) OR THREE PLANS ATTACHED: <br />�x . . . r�,?r. ,a�- .. . . _ <br />t �. �y �,�K x ,;.� ��� . <br />. tr � c r { ,c,t t.�r,. <br />t;� ���: � � s ,r e..:i. . +' . <br />_ + � `5^`�. +-�3":' <br />p �' <br />Y '_4 ry.� yF� <br />t i. �~ YY Y`:} t <br />h � � �, . n T . + <br />:.1: �» .{ 'e j , f �� <br />1 �i <br />� U , <br />,,'r •*- <br />4 s ti <br />� CM1 � <br />i,� <br />i5 i ' <br />i <br />'T� .+A. <br />�W l <br />�f. " " ^.� ' <br />'^ <br />� � ��S <br />�3:. <br />j .. <br />F'IEFiMIT OS \i,Q1LID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CdALL FOR IP1SP'ECTII?N 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEwER <br />❑aawncE <br />DEPARTMENT APPROVALS <br />COAIMIINICAT10N5 ----�'�" � <br />.,.,�� :....ri <br />PLFNNING <br />. S <br />� <br />�J79 <br />C <br />:� <br />DRIVEWAY SECTION <br />� +I'� LIP <br />� 30" � I 30" <br />�, .�. <br />T�e un0ersigned owner hereby agrees lo hob an0 save harmless <br />Ihe City ol Everei� /rom any antl all cloims lor damages. costs. <br />rxpenses. or causes ol action that may orise because ol installaaon <br />antl maintenance of ihe improvement or o��er nghbol-way use <br />hereto apOhetl lor antl lurther agrees to remove same vpon noiice <br />Irom Ihe Ctly ana to replace pu�lic propetly damagetl Ihereby. <br />a?cl/ � <br />IGNAiURE OF APP�ICANi <br />�(�j!/D /7,o/�u • <br />n_DAES� <br />L .v,uu.�x� G�a� y8o3�' <br />L� ZIP <br />775 -lc /S U ,�SS-o2S S <br />TREPHONE NUTAE3ER q�iEqryqTE <br />� -i- �9 <br />COiVSTRUCTION/ASuUll:i FEE �978 <br />