Laserfiche WebLink
� <br />everett <br />e <br />CITY ENGINEERS <br />ENERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />1�058 <br />7 7/ <br />PERMITNO._��5�� _ <br />� <br />TheUndersigned _ ' ��T/'��/��� �!i/^��h//71iJL-I� <br />Hereby applies forpertnission to �O .�l S T�.� c.T A /7 �,�St�/� �! ' /i�vJ <br />At the following location Z s/ Z-� l7i� !,-' ?/ C,�A/ `= 7" <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />�— -- -� <br />I�� LIP <br />�3�—_— _�30 �1 <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON J06SITE. <br />CALL [NGWEERING DEPT. 259�8871 <br />2•7 IiOIJRS �[FOR[ CONSTRUC110N <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 />, ��PY �° F��L 110 5 8 <br />1 Copy to Inspector <br />S.fc �; i7f1�'iF_D <br />The undeisigned owner hereby agrees to hold and <br />save harmless ihe City of Everett from any and all <br />claims tor damages that may arise because of ins[alla� <br />tion and maintenance of the improvement hereto <br />applied for and turther agrees to remove same upon <br />notice from the City and to replace public property <br />dam d the eby. <br />Signature of Appl' t <br />�� <br />Ad ress ��^ , <br />�• . t11'�....� <br />Telephone Number <br />353-3�sy <br />1-ee " � >; <br />�De�pprovals <br />Engineers /- y � <br />Communications <br />Approved by <br />Da[e Approved <br />