Laserfiche WebLink
WAPPLICATION FOR RIGHT-OF-WAY USE PERMIT 10643 <br />CITY ENGINEERS PERMIT NO. <br />EV E R ETT, WASH I N GTON <br />.y <br />- � f <br />The Undersigned <br />Hereby applies for permission to � <br />At the following <br />(Work to be done) <br />• <br />i'. <br />�1 <br />DRIVEWAY SECTION <br />� NO SCALE <br />i <br />11 l" LIP <br />1 <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-6811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk �, <br />Itor's Si nature �,--� <br />ate <br />Note: Original to Customer <br />1 Copy to File 10 ; 4? <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 further ag—es to remove same upon <br />notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant <br />Address <br />LD <br />Telephone Numb r <br />Date <br />Fee <br />Dept. Approvals <br />Commun <br />Approved by <br />Date Approved <br />