Laserfiche WebLink
1 <br />�' ;_��j7�Z <br />APP�iGATION FOR RIGHT-OF-�IVAY USE PERMIT <br />Type or print clearly with irk <br />� PRESS HARD - YOU ARE MAKING COPIES <br />PUDLIC WORK; / <br />EVERE+T.V�ASHINGTON PERMIT I�'O. ��L(,zf�— <br />.-'�� �^ �,` � <br />APPLICANT (UNDEfiSIGNED) AND FIR�d REPRESENTED, IF ANY:_i�_��L���C�I/S�T� G✓ ���iP1f� �_ <br />HEREBY.IPPLIES FOR PERMISSION TO�(//J/�?T.PLICT /_/�tN/ �(�f- /�ii%�i�jP�-P!Jl�IL-_L�j'�-,�/�_ <br />� �u srr�,�� ' <br />AT TH� POLLOWING LOCATION '-'-30-�- NISS/.'U iGiC ; E!/C�ir�� /�G.. iJ�10/ <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />� f%P�.f1J//.c`DS�.l�L'TTD i/i'� F4�1-ai�i/e1�.' ' + <br />/, sl��'i�'/C.9Tia.C/.� �O� ST.���T /wI�.PD/`t/�E/1/� a��'"�/G,5 <br />Z. CfJT�f/�'/�.Si,��� Sii'r.�GL �,�_ �9,oi�/�9 TJ'��-_7Is j�iT�i'LG�,�i�. <br />� iDs <br />3, 17r�/C��rJ,r=l�//��'T/DitJ rD.� d�/c>E,' F�uJ �N Cc.�Jr.� <br />-� L�.9>C'H r�'f�/.1/ ' <br />�/, o,���%�� ra �c �i��ti'i�r1c c� z' <br />5. S�U.!�� ��.rJd1�� r�a,�1 P<2 �ilJf�� D��,e.95-id�JaF <br />itld.0 s���t//Fi���r/�c <br />6, G��,�iF��Tia.rJ omzJ it10 i� 6 of" b,�f�i�11�� ���rl <br />�i5'�" �i�ffiL15 S/1/9� .�,C .�c ///SG� Ta //1JJ)/L�f'T.c T�'�_S� <br />��y/��„C�'�Sf/IJ1S; �G=SGI,B�I/7.��f� -�Lt/f)S Fb55t�,�, <br />� ��tiCJ % lc'�Cc /V�1� �.tJl � h�i� 5�i9 %S f1 � iDf' 1�c%0�.� <br />I D�DC,e ���%GG .B� /SSl,��� .,�^ , . , , <br />PERMIT IS VALID FOR 60 DAYS <br />� COPY QF THIS APPUCATION TO BE POSTED <br />I ON JOBSITE. <br />' CALL FOR INSPECTION 259-881 1 <br />I� 24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEIVER _ COli1�UN�CnTHiNS <br />/ <br />� . <br />pRAINAGE � -� � � . TRAIRC � � <br />WATER . PVNNViG <br />SiHEFi '- <br />V <br />��' <br />i'i�F':S�i;UCTIONii�; L'UII T <br />!� <br />� <br />JRIVEWAY SECTION <br />I � <br />+I" LIP �� <br />L30" — __f_,30" <br />i - �r- <br />The undersigned owner hereby ogrees Io holE and save hnrmless <br />Ihe Ciry p� Everell Irom any an0 nll clmms lor damaqes. costs. <br />erpenses. or causes o� action ihat mey anse because ot mstalinbon <br />dna mimtenance ol Ibe imOrovemenl or other ri�bl-oFway ost <br />Oereio applicd lor antl Iuri�er agrees to remove Same u0on nobce <br />Imm Ihe C�ly and to replace pubh� property tla� �aoec mweby. <br />�.h'" , -> ;`":/� <br />�noH[r�un�oEn a�iEqrvnrE <br />�I <br />