Laserfiche WebLink
—r <br />everen <br />e <br />APPLICATION FOR RfGHT-OF-WAY USE PERMIT <br />Type or print cleerly wi�h ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS Q pS <br />EYERETT, WASHINGTON PERMIT NO. U� �� <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: �G'��lZ � SCN O F�/3�`- K� <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION 6i'� <br />DRAWING (WQ�K TO BE DONE) OR 7HREE PLANS ATT�HED: <br />3 <br />a <br />v <br />� <br />2 <br />-. , � � <br />� � , <br />I � <br />E xs'• �R. � <br />, � <br />1 �' � <br />'J - <br />� e e ��g �C LCe�ZNIF�� , <br />lZ�(=�_.�aCCNIeNi 7JE � <br />I rJs�i1�L A i IcN pr WA,-e 2 <br />LtNC 3�( c.�-t-y �c+JT�zt\c.�� <br />PERMIT IS VALID FOR 60 DAYS <br />GOPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DEPARTMENT APPROVALS <br />COMMUNIC/ TIONS <br />ORAINAG[ TAA��iC <br />WAtER PLAHNING <br />CONSTRUCTION/AS BUILT <br />DRIVEWAY SECI�ON <br />� � <br />+I" LIP <br />� 30 �i �l'30 'J <br />r � <br />The under5ignn0 owner �ereby egrr:s �o hold antl save harmless <br />the Cily ol Everett Irom any and all cleims lor tlamages. costs. <br />e.penses. or causes ol action that may anse because ol installalion <br />and mamlenanCe of Ihe improvement or olher righ4obway Use <br />hereto ap0��e0 br an0 lu�lher agrees to removc sam�, upon not¢e <br />Irom Ine Cny antl to �eD�ace pubbc pioPerry Oamagetl Ihereby. <br />%��v%� i�S �-03 - <br />��- Z�P <br />�.S^3 - 23 � z <br />iEL P�iONE NUMUERr' AL�ERNPiE <br />`' � � V � _ <br />DATE <br />1978 <br />