Laserfiche WebLink
!v� APPL iCATION FOR RIGHT-OF-WAY USE PERMIT <br />� TYPe or Print cleerly with ink <br />PRESS HARD - VOU ARE MAKING COPIES <br />PUBLIG WORKS <br />EVERETT. WASHINGTON PERMIT NO. . <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANV:_ <br />HEREBY APPLIE� FOR PERMISSION TO �� ��� T 6�j/��" <br />AT THE FOLLJWING LOCATION � l L � � - �� ~� � � /�" " � `� �� � " <br />DRAWINd (WORK TO BE DONE) OR THREE PLANS ATTACH:D: <br />PERMIT IS VALID POR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-681 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPAFiTMENT APPROVALS <br />� <br />SENER �� .�„ �'� GOMMUNILAI�ONS <br />�� �� <br />� " � <br />DRPINAGE T � 1PAfFlC <br />WATEA <br />STFEET ' i C <br />� �' J <br />PIANNING <br />qpPqOVEO FOR CONSTRUCTION onTE <br />qpPROVEO AS CONSTRUCTED DAtE ' <br />INITIAL INSPGCTIOId R[QUESTED <br />q°%%'l ?�Z%�79 <br />DRIVEWAY SECTION <br />I'� LIP <br />�3p'1' � ' �_,r30 � <br />r <br />The un0ersignetl owner hereby agrees to hold antl save harmless <br />Ihe C�Iy ol Everefl Imm any end a0 cleims br Oama9es, tosis. <br />expenseF. or tauses ol action I�at may arise because ol mstallahon <br />and mamlenance ol Ihe �mprovement oi ot�e� ngh�-ot-way use <br />bereto aPphed lor and Iurihe� agrees to remove 5aae u0on nolite <br />Irom the Cily and to reDlace public p�operly Oamaged ihereby. <br />$IGNl�tU�[ Of FPPLILANt � �- <br />�1 . '_ <br />CitY LP <br />� � - . <br />iELEPMONE�NUMBER RL1[RNPIE <br />_ I ': -. � -� '� - - <br />