Laserfiche WebLink
everett <br />�� <br />CITY ENGINEEkS <br />EVERETT, WP.SHINGTON <br />The Undersigned ___�(_,__ <br />Hereby applies for permission to _ <br />A. the following locz:ion <br />S�=TCH <br />(N'ork to be done) <br />APPLICA'f10N FOR RIGHT-OF-WAY USE PERMIT <br />N, ,.- . . , _ _ . . <br />J� . .;�....;�, 1� � ;�.�,,:n <br />'�No Pqrhir�y. �� � <br />QR�VEWAY SECTION <br />NO SCALE <br />r — >c -� <br />� tl�� LIP J� <br />I 30'-.�.__ _. `--___ . _. __�,30� <br />I COPY OF 1"HiS APPLICATWN TO <br />f,E POSTEG ON JOBSITE. <br />C,1L1,. ENGIIJEERIWG DGPT. 259�8617 I <br />, .'��U'.li?:�.C;_FORECONSTRUCIIOP��I <br />CHECK LIST <br />Water Valve� <br />Drainage <br />Ccr6 & Gutter <br />Sidewa�k <br />,w e,�;t� <br />� <br />''�l",..r','J,.••�,Y,i°• v'`s�-.�i�;.,�,�;.a.�..�. <br />Inspector's Si 'nature � � <br />!� , � `�'l"rf .�+ / / <br />rr � � <br />-�te —_ <br />Note: Original to �ustomer c <br />, L) <br />1 Capy to File 1�;�, � <br />1 Copy to Inspector <br />�7 <br />'1Q486 � <br />, � <br />PERMITivO. �b-//_? <br />' x IE� .1ob Shnck <br />The imdersipned owner herety agmer to hol.i and <br />save ha�mless the City of Eve.ett from any and all <br />claims for damage� that may arise because of installa� <br />tion and maintenance uf the improvement hereto <br />applied for and further agrees to remove same upon � <br />notice fr�m the Citp and to replace publia�roperty <br />d�a�m7a5ed th reby. / �� <br />� <br />iJ�,�Sol✓�`. {"r ,�in�o � P.SiC�.'.. <br />Signature of Applirnnt <br />�In� '� -/nF'n/ ST. Br��F!/rIP <br />Address <br />.9�.z� - 9 Q Si Sr <br />Tele, ��one Number � -� <br />i" �' �( <br />Da e - <br />No Fcn <br />Fee <br />De t , pr v� 2��, <br />En�ineer 'r � <br />Water <br />Street �irl/,_.� . , . <br />Communications <br />Traffic <br />Plannin . � � �7� <br /><'.'�✓- ��-� -Ii�...L,la��=-ir-�'� , <br />! <br />Apnroved by o <br />Dat� ed <br />6 <br />