Laserfiche WebLink
,�, - -- �- <br />. <br />APPI.ICATfON FOR f;IGHT•OF:'JAY USC PERC�IT <br />cvcretl <br />�1.U�G?. <br />� <br />� <br />CITY [NGINE[RS . 7 <br />EVERLTT, WASHINGTON PL-RMIT N0. �' ?�" __ <br />i <br />TheUnc+:rsi9�ed ):��•f/1I��Qh�ti�/1 t� <br />i <br />'Hcreby applies for permission to ��=1(�UG 7� I'a" �_��S'��i�� � �% �n/ <br />At the (ollowing <br />(Wo�k to bc done) <br />S�E A�iT,aGfIGO <br />DRIVEWAY SECTION <br />NO SCALE <br />� � <br />�tl'_LIP _� <br />I 30' I � 30' <br />i'�..�1�__ _—.�..'—..I <br />COPY OF THIS nPPLICATION TO <br />�C POST[D ON JOftSIT[. <br />CALL GNGW[['TING DEPT. 250•8Ei11 <br />24 HOURS OE�_OR[ CONSTRUCTION <br />CHECK LIST <br />I Wamr Valve <br />' Drainagr. <br />Curb & Guttm� <br />Sidewalh <br />Incpecior's Sipnature <br />Hemaiks <br />Now: Oiipinal In Cusloinrr <br />i Copy �o Pilr ( r•• <br />1.)9��;_ <br />7 CopY Io liupi�clut <br />Thc undcrsigned owncr hereby agrces to holu and <br />savc harmle;s the City of Everett irom any and all <br />claims for dama9es that may arise because of ins!i!la• <br />tion ana maiotenancc of thc improvanr.nt hcreto <br />applicd for and further aprces to icmovr, same uPon <br />n tice (rom the Ciry and to reptace pubiic pruperry <br />da�i� ed th�ic y <br />_ � 7�J�....� <br />�-� � -=-- <br />Sig�i aturc ot ApP�ican <br />.�`_'�IF_.� : L�/c-c��JiaY,�h L✓'�7 <br />Address <br />�s_.� '� �7 �C1 <br />Tcteplionc Numbcr <br />�b� �� ��� - <br />Date � <br />Y/ /0= - <br />J <br />FCC <br />�cNt. A��n���,�:,is <br />Enpineers��t�/r�`�`� � <br />Sdcet <br />Cornmunications <br />n�,i,�<��«i i�Y <br />n,n., n�,,�i m•m� <br />