Laserfiche WebLink
� $%�f,'�o7 <br />everen <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print cl^arly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS PERMIT NO. �� -�� — <br />EVERETT,WASHINGTON <br />e'. . . . .,,1/i /—d'n/ i ��. l��PTGIO� -- <br />APPLICANT �UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBV APPLIES FOR PERMISSION <br />c: <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THqEE PLANS ATTACHED: <br />��JJ2/L TD %j� <<��I�/°L2iyirJ /iLCc-i?iJi.�t— 7Z� <br />P Ai%1�fGf�lO %2�J.0..-�v� fDe <br />� ;s �� Sh O <br />2J " Lvodw <br />L�oU i <br />�/i✓L�-!�rl� S��'/GG£ <br />PERMIT IS VALID FOR 60 OAVS <br />COPY OF THIS APpLICATION TO BE POSTED <br />ON JOBSITE. <br />CpLL FOR INSPECTION 259-861 7 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWER <br />pFA1NPG[ <br />W Pl <br />CUMMUMC4i1C'JL <br />ippPFlC <br />p�pNNING <br />�; u, - - <br />APPROV H CONSTR CTION ��TE <br />� 0���� ; �l��i� � <br />RO�� AS CON CTfiO � n�E <br />CONSTRUCTION/AS BUILT <br />DRIVEWQY SECTION <br />I --� <br />`�,� ��P _ _ <br />� 30,� / : _�_3� ; <br />�— � ' <br />The undersigned owner hereby agrees to �oltl a�e seve hermless <br />Ihe Ci�y o� Evercit Irom any antl e11 claims tor dameges, cosli <br />e�penses, or causes ol action ihat may arise because ol mstallation <br />an0 mantenance of Ihe im0�ovemeM or other nghboi-way use <br />hereto epphed lor Pntl turlhe� agrees lo �emove same vVu� �obce <br />trom Ine C�ly and to replace V��hbc p�ope�tY Aamagr0 ���ereby. <br />�% � /� <br />i-/-'�ii�,/ �/ / ��i=�[�V ��' —_ <br />SIGNRiUNE Of APPUCANI / <br />/' J/ /��i,c�v.. �J <br />npDAESS <br />CvUr� �-)o, �riZO <br />Gir• <br />C �� �/��� ALTERrvPiL <br />1CLEPMON[ MUMBE� <br />��/a��gl --- <br />onie <br />