Laserfiche WebLink
� everen <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />Hereby applies tor permission to <br />Atthefo�lawing <br />(Work to be dane) <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />.� �I 1 � � <br />DRIVEWAY SECTION <br />NO SCALE <br />r--- - - --� <br />I" LIP <br />�a.l.__ _. _ . .w30�r <br />COPY OF THIS APPUCATION i0 <br />OE PpSTED ON JOBSITE. <br />(:ALL ENGINEFRING DEPT. 259�8811 <br />I 24 HOURS BEFORE CONSTHUCTION <br />�- --- -- - --- ------ <br />CHECK LIST <br />Watar Valvc <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspectcr's Signature <br />Remarks <br />i �. <br />1. _ '. <br />P[RMIT N0. � � <br />The undersigned owner hereby agrees to hold and ' <br />save harmless the City oi Everet[ from any and all '� <br />claims for damages that may arise because ot installa� <br />tion and maintenance of the improvement hereto � <br />applied for and further agrees to remove same upon � <br />notice from the Ciry and to replace public properry � <br />damaged thereby. �. . i <br />�+� L(s ^ � (f (� � , <br />SignaWre of�Applicant , �� <br />/ , � .- _. -.. - . . . � . � <br />Address � <br />=� ,� _ �-� -.� � .i- <br />I <br />Telephone Number i <br />I - '�. % �' . , �� <br />Fee <br />Dept. Approvals I <br />Engineers � '� <br />Water <br />Communications <br />Plann <br />Apprwed by <br />1n� <br />, Date Approved . <br />a <br />