Laserfiche WebLink
_ F,PPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> - everett 1 0 O�C _ , <br /> 1 J -� <br /> � I <br /> CITY ENGINEERS �// <br /> EVERETT,WASHINGTON � PERMIT N0. / ���� <br /> Go�z� cUUS �-�IST ' <br /> � The Undersigned , <br /> - Hereby applies for permission to �.A L�' �'t'`C'� �� <br /> OF� JI�CWAI._iC A�14� 1��1t �'��NL� l7�tl {�J3�_� O ' <br /> i � 1 d' � ' <br /> At the following location � Z�Z 1V �) � �lcr� �. <br /> � SKETCH <br /> � (Work to be done) H �w �� H�E• I <br /> _ � <br /> � <br /> ,! i <br /> ' ,' � � <br /> ; 3 j <br /> I fXlfT/NG `� � <br /> I /8'CAf/C. •; <br /> D�W :.' N <br /> K; p I <br /> II �� ;; � I <br /> � ,;; <br /> :, <br /> � <br /> I <br /> F� CE CDNCRETE ' <br /> , � JETWEE/V B/aCK OF ' <br /> 0 SIG�'WALK � 8U/LDING <br /> � � I <br /> ( d <br /> , � <br /> � <br /> I DftrvEWAv ;�C7i0N � The undersigned owner hereby agrees to hold and <br /> No SCALE C save hartnless the City of Everett from any and all <br /> �I �� ----+� R� claims for dameges that may arise because of installa� �1 <br /> � �, ��fi.� tion andmaintenance of the improvement hereto <br /> I applied fo�and further agrees to remove same upon <br /> I 30�� I __ 30" notice from�the City and to�eplace public property �� <br /> I~—^�'�— damaged tf '.S�J �/ I� <br /> x l' ' /,7S_�G�— <br /> Si ure7.OApp�can����� p��_ <br /> ------ ? �/ �' �/f �-(�CY <br /> COPY OF THIS APPLICATION TO 43��1 pddress�j�_ j J_ �[�, <br /> II BE POSTED ON JOBSITE. <br /> Telephone Number <br /> � CALL ENGWEERING DEPT. 259�8611 x �_ �!'� �C, <br /> 24 HOU3S 8[FORE CONSTRUCTION Date ' <br /> �-- ------ .UG; �E� <br /> CHECK LIST Fee <br /> �. Watar Valve � n <br /> �� �e�er�Ox DeP �p roval <br /> Drainage � p 5e �/� I <br /> � Curb&Gutter Engineer <br /> � Sidewalk �Water � � <br /> ////�J�y\_1��� / �(fGt Street d ," , I <br /> � �,.,.„„��„� /J� �d"' Communications ', <br /> �Inspec�or'sSignamre � / 1 �I <br /> Traffic o2 <br /> t/ i <br /> '� �� —//� �/ Planning�� �_ ��.u-' � �� i"' � % <br /> ate <br /> Remarks <br /> � <br /> Note: Original to Custemer ` '� <br /> , icaPv,or�i� �0085 '•, <br /> �. 1 Copy to Inspecto� Approved by , <br /> � i <br /> ' Date Appro d '� � <br /> / ;G, �, 1� <br />