Laserfiche WebLink
everett <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />v Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS Q <br />EVERETT, WqSHINGTON PERMIT NO. UI �S <br />APPUCANT (UNDEHSIGNED) AND FIRM REPRESENTED, IF ANY: �G�'/A�� %� �C"'N p�/3.� �/ <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION <br />YC ,c/ <br />c J Ma�GAN <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATT�HED: <br />3 <br />� <br />� <br />� <br />� � <br />.. ' J , <br />� � I <br />G ,�5;-. ��Z. � <br />\ <br />�--�'--�~ � <br />j " I <br />' � � <br />/ <br />S �� �og c ��' rLM�11� . <br />IZ�-1,�-���CMCNi <br />I�iSii1�LATICN p( <br />��Ne 3� �„-Y <br />"i7JE � <br />�u,4�-e �� <br />� o,v�T�z��c.�� <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION �59-98/ 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />WAtEP <br />STRE[T�— <br />���/li <br />DEPARTMENT APPROVALS <br />COMAIUWCATiONS <br />TPAfRG <br />PLANNING <br />C.Oi'!;��� �'! iCT�ION=ItS [3U11_T <br />/ <br />v. <br />I� <br />ORIVEWAY SECTION <br />� � <br />j I'� LIP <br />�30'� _I_30" <br />-T- <br />The untlersigne0 owner hereby agrees to ho10 end save harmless <br />the Ciiy ot Everett Imm any an0 all Claims for damages, costs. <br />expenses. or tauses ol attion Ihal may anse becausc ol installation <br />2nE ma��tenance OI I�E imp�ov¢mCnl 0� o�her nghi-Ol-wLy u5e <br />herelo appbetl br an0 lurther agrces to remove same uDon notice <br />irom ine Giy and Io replace pu�hc prope�ty damagetl Inere�y. <br />��,..�..�1 g� �a� <br />�i z�� — <br />_�.�3 - 23 � Z <br />tEL PMONE NUMpER aLiCRNAiE <br />3 - s-�i % <br />OPIE _ ' <br />�� <br />79i8 <br />