Laserfiche WebLink
APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> `�"�" 10403 r�"�1 <br /> e �3 ,��,� : <br /> CITY ENGINEERS ` '�G.�� <br /> EVERETT,WASHINGTOt�� ; PERMITNO. <br /> j �,-, y / <br /> TheUndersigned ��i'Tl �„ � '����(�t.s%�t-r:-�-�-f3'/1 I, <br /> Hereby applies for permission to /_,.c rr 2�' � �-'� � Q��'+� _ ' <br /> At the following lowtion '�G� r-r'--��r--!-�-�.�. i'%l-�^a � <br /> I <br /> � SKETCH ��. <br /> (Work to be done� � � , <br /> , �5�� ,/ I <br /> � �� ; <br /> ' � ! <br /> /� ; I <br /> ' ' � <br /> �� i � <br /> `� E'x�sr��c � ; I <br /> � ��• i,✓G E/' � <br /> I <br /> i <br /> I <br /> �\\ �1 G�NsT � Pi1�=IGi r�rv <br /> �'I - N I <br /> i� � -n i ' , , <br /> �i I 75zi � � <br /> — i <br /> � <br /> � <br /> ,, <br /> �i DRIVEWAY SEC710N The undersiyned owner hereby agrees to hold and <br /> ' NO SCALE save harmless the Ciry of Everett from any and all � <br /> ' '"-- Zr�� � �� � claims for damages that may arise because of installa� � <br /> I" LIP � l tion and maintenance of the improvemen[hereto - <br /> � � � � � applied tor and further agrees m removr,same upon <br /> �3C'�_.____ _�30" ��{,If'/-'�_,/� , notice from the City and to replace public property ��� <br /> r� <br /> � �J'�"�/� dama9ed there6y. �� ) I' <br /> .. �"' ' �/ .7(� Q S/P 1�/CX�I�J/Lf/y7 / i <br /> Ki <br /> i� ((l Si ature of Applican <br /> -- 3' 7 s�- � E . ���.r�,��r-,� c.�J�rr ' <br /> . COPY OF THIS APPLIL'ATION T0� Address �.� <br /> � BE POSTED ON JOBSITE. e V E Y� C TT ��F� <br /> I � CALL EIVGINFGRING DEPT. 259�8£111 I Te�ephone Number � <br /> � 3 - 13 �Z <br /> � I24 HOURS i1G�OHE CONSTRUCTIONi Date 3 �j � <br /> _ - -- /f�•lY� �i/• ��9��[L_ <br /> ' CHECK LIST . Fee �� <br /> �Vater Valve De t. pr 1 <br /> �, Drainage <br /> Curb&Gutter • Engine 3 / / <br /> . Sidewalk Water e a-ti � 'ea/�SCyG $� '. <br /> ' ��l Street /.���,,� <br /> �� / �' r � > <br /> Q,/�,�/ •- •- ��-' Communicatio s <br /> �� �qapector's Sig a[ e � <br /> / Traffic 7n <br /> /- Planni / <br /> �i- .S- 7t� ew<P �'., o � �� <br /> �ate - <br /> Remarks I <br /> �. Note: Original to Customer — <br /> , �oPv �o F��� 10 4 0 3 — <br /> 1 Copy ta Inspector Approved by J-� � <br /> \�1 � / <br /> Gate Apnroved <br />