Laserfiche WebLink
APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with ink <br />Ej <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON _ PERMIT NO. <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />f!/ <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />WATER <br />STREET <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />TRAFFIC <br />PANNING <br />APPROVED FOR CONSTRUCTION DATE <br />I, APPROVED AS CONSTRUCTED GATE <br />I <br />DRIVEWAY SECTION <br />+II LIP <br />I- 30" l 30" <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs. <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged thereby. <br />3s3- 7S ya - 3s3 - 2 rq 7 <br />TELEPHON NUM ER ALTERNATE <br />FON led <br />DATE <br />REFERENCECOPY FEE 1978 <br />