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129 MADISON ST 2016-01-01 MF Import
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129 MADISON ST 2016-01-01 MF Import
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Last modified
4/10/2017 10:31:39 PM
Creation date
2/17/2017 9:47:05 PM
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Template:
Address Document
Street Name
MADISON ST
Street Number
129
Imported From Microfiche
Yes
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, .. .. . N . . . <br />' . irK. .. �..� . . i, r'. . . . <br />:y �' <br />� . � . . . . . . ,a . � . . .. ' <br />7: <br />APPLICATION FOR RIGHT-O.F-WAY USE PERMIT � � <br />�ryp. w a.�M ow.nv .mi �n� <br />' PRESS HARD - YOU ARE MAKIN(i COPIES <br />��C wo�cs PERMIT N0.1� <br />ev�nErT. w�mxwaTon <br />APPLICANT (UNDERSIONED) AND FIHM flEPRESENTED, IP ANY:�" ��-'� ��E" � S� T� �c� -� <br />HEREBY APPI.IES FOR PERMISSION TO G �`�1��'�T� �G �, �'� ������� G% L�/GU � __ <br />AT THE FOLLOWING LOCATION � ' � � " � � <br />DRAWIN(i (WORK TU BE DONE) OR THREE PLANS ATTACHED: <br />Cl,�c� S/�✓ <br />PEfiMiT IS VALID FOR 60 DAVS I <br />COPY OF THIS APPLICATION TO BE PaSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />� <br />DEPARTMF'JT APPROVALS <br />SEWER CGMMl1N�GFTiONS <br />DRPINAGE <br />PLA4NMG <br />STREET <br />��t- S�ti� 7 9 <br />pPP OVE FOR CON TRUCTION D>�E <br />APPROVED AS CONSTRUCTE[1 D�TE <br />I�diT�AL INSPEC710N HEQUESTtU <br />DRIVEWAY SECTION <br />I" LIP _� <br />30,� � �_30"_� <br />TM1e unders�gned owner �ereby agrees Io hold antl save harmless <br />Ihe City ol Everett hom any anE all clxims br damages, wsis. <br />expenses. o� causes o� ac�ion Ihat may anse tiecause ol mslallation <br />�an� mainlc��noce o� ibe improvemen! o� c16a ngh4obway use <br />ne�elo a00beA lor a�0 luriner agrees lo �emwe same u0on not�ce <br />rrom the Cny an0 to repince public p�opeity Oamagetl tnereby. <br />SIGNn*URE Of Acv�ICPNI <br />TELEPHONE�+UMBEA ' ' n�1E9NATE <br />
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