Laserfiche WebLink
everen <br />�y � <br />CITY ENGINEERS <br />EVERETT,INASHINGTON <br />APPLICATION FUR RIGHT�OF•V1'AY USE PcRMIT <br />1�909 <br />PERMIT N0. � � <br />The Undersigned ����' � _ 1� iv G -a ti"y__� � � _ — <br />Hereby applies tor permission [o y rniS-1i<�/� T a �-�i y�.? i`�l' •t �= fr i 1�.� — <br />/ <br />At the following location �-/ ?� ni ��F � Ja i7 i� w _ _ <br />(Work to be done) <br />SEr r'i�i�icN;O <br />DHIVEWIIY SECTION <br />YO SCALE <br />� � <br />I" LIP <br />�°�+ #— �so��,� <br />rCOPY OF THIS APPLICATION TO �. <br />BE POSTED UN JOBSITE. <br />CAI_L ENGINEERING DEPT. 259-8811 <br />�24 HOURS GGPORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1CopYtoFile �.0909 <br />1 Copy to Inspector <br />The undersigned owner hereby agrees to hold and <br />save harmless ihe Ciry of Evere[t from any and all <br />claims for daniages that may arise because of installa• <br />tion and maintenance of the improvement bereto <br />applied for and further agrees to remove same upon <br />no?ice from the Ciry and to replace pubiic property <br />�da ged thereby, lll;, �1. /.i��e,l� <br />i i rIJNG�4fz0 R; <br />$ignaWrn ot Applicant <br />�i(a3 .Uv���r��� r�/. <br />Address <br />�����de <br />Telephone �umher <br />7— 2�- �� <br />Date 4"p SN <br />—1� 0,2�� . — <br />Fce <br />Dept. Approvals <br />Enginer.rs <br />Communirations <br />Planrt'ng_ <br />Approved 6y <br />Da[e Approved <br />