Laserfiche WebLink
everett <br />� <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the foliowing <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />SKETCH <br />(Work to be done) � . <br />�c�r ��:,,�,: ,��.v <br />i DRIVEWAY SECTION <br />NO SCALE <br />r--- - -� <br />�I" LIP � <br />' I 30'T—._ —_—�1•30,�1 <br />Ci)PY OF THIS APPLICATION TO <br />6E POSTED ON JOBSITE. <br />CALI. ENGINEERI(JG DEPT. 259�0811 <br />��t I10URS fIEFOR� CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewaik , � � . � <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1 Copy to File ��1 7 � s <br />7 Copy to Inspecror <br />. �. 'r . '. . . <br />10716 <br />PERMITNO. � �" %i Z <br />2 <br />The undersigned ownen c�reby agrees to hold and <br />save hai•nless the City of Everett from any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of rhe improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City und to replace public properry <br />d2mage thereby. <br />; ;,� - �7 /;, <br />Signature of Ap)plicant �1 - <br />/ � .' -/ U f �J ___�_ i l . ��1n /, � <br />Address <br />� �1 <br />.� /� <br />� Telephone�Number <br />1- //_� 7-J <br />Date <br />Fec <br />Dept. Approvals <br />Engineers � � <br />Warer � " '� r � <br />'- Street � � <br />Communications I <br />Traffic <br />Planning <br />Approved by <br />Date Approved ��"'� <br />