Laserfiche WebLink
APPLICATION FOR RIGHT-OF•WAY USE PERMIT p <br /> everetl 3 0 5 4 3 <br /> � e � <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT N0. —�'� <br /> The Undersigned �— '-- <br /> �, Hereby applies for permission to <br /> At the following location �.S C �4 ��t'�_ A v c — <br /> SKETCH <br /> (Work to be done) <br /> � <br /> I�I � � � � i '� i 10 ----� <br /> b <br /> -'I� � I __'_ � <br /> i ' � � <br /> ld I \ 2 9 I� ' n s p�,. <br /> � � ,<,..�. - — <br /> Q � ..� ,,, ----- � <br /> �� � � b <br /> � <br /> � � -- - <br /> � � �� i � <br /> � � � 1 � � ' --5- �t <br /> � i _ � <br /> v <br /> � �, ���� � �� <br /> a ; <br /> l7 : r � _ <br /> �� <br /> � 3 ` , <br /> I -a `� <br /> i ` I F/� <br /> � , <br /> I _- i �� � <br /> 1 � I: — - F/L <br /> � <br /> N�� N„ S� �.; l�� ., <br /> �K-i.V �/��^/'(n <br /> ' DRIVEWAY SECTION The undersigned owner hereoy agrees to bold and <br /> NO SCa�E save harmiess the City ot Everett from any and all <br /> � X ------{ claims tor damages that may arise because of installa� <br /> tion and maintenance of the irrprovement hereto <br /> �--�,—��� ��P � applied tor and further agrees to remove same upon <br /> h30'+ _} —.._—.__�3� notice from the Ciry and to replace public properry <br /> � damaged thereby. <br /> � � Signature of Applicant <br /> : i �� COP'/ OF THIS APPLICATION Ta '� Address <br /> IBE POSTC-D ON JO�:iITE. -�. � , \ ��� Telephone Number <br /> � CALL ENG�NEERIfJG UEPT. 25J-8811 I \ _ <br /> ' ": IiUUHS HCf-ORECONSI�RJCTI�NI, , Dat� <br /> I CHECK LIST — �—� --_. . -- - � ' �\ 1 �� Fee <br /> Water Valve \ I Dept. Approvals <br /> Diainage •,, Engineers <br /> Curb&Gutter <br /> Sidewalk Water <br /> Street <br /> Communications _ <br /> Inspector's Signature Trafiic <br /> Planning <br /> — — .>�' n --.. � -7 d ��'�i.t�f r!'� <br /> atc � , j'r tL.o�. �,Ga �� �.c._ <br /> `�• <br /> Remarks \ � <br /> Note: Original 'o Customer <br /> � ��PY �� F��� 10 5 a 3 — <br /> ' i ^.opy to Inspector Approved by 1Z � /' /��� <br /> l) � <br /> / <br /> Date Approved � � ,7—�-- <br />