Laserfiche WebLink
APPLICATION FOR RICIIT•OF-WAY USL PILBRIIT <br />cvc tt•11 <br />11078 <br />CITY ENGINEERS - <br />EVLRET'T, WASHINGTON PERMIT N0. �;' <br />��;> O <br />The Undcrsigncd,Lo�i!ct. <br />Hcreby applies for pennission to <br />At the following location _.n.�� I/�lF��;:;c,.•+�) , <br />(Work to be done) <br />SM <br />DRIVEWAY SECTION <br />NO SCALE <br />I" ur <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 2598811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LISP <br />N'ator Vaive <br />Drainage <br />Curb t'i Gutter <br />Sidewalk <br />Inspector's Signature <br />—Date <br />Note: Original to Customer 1Copy it) File 110,18 <br />1 Copy to Inspector <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa. <br />tion and maintenance of the improvement hereto <br />applied for and ��f�other agrees to remove same upon <br />notice from�h/•City and o replace public property <br />damaged 1: by, _ <br />Signa rc o� Applicant <br />Address <br />/'1lc1A'/ram (///. 17,gt7 <br />Telephone Number <br />Date <br />//. 4 ??` <br />Fee ti%Z <br />Dept. A)'f'ro als <br />Enginccrs_G <br />Water <br />Communications <br />Planning <br />Approved by <br />Dalo Appiuved <br />