Laserfiche WebLink
-�-� <br /> J <br /> AP� CATION FOR RIGHT-OF-WAY USE pER1A1T <br /> evcren �n O q ^ ., <br /> lJ 1 ZS <br /> � <br /> CITY ENGINEERS _ / 2 � <br /> EVERETT,WASHINGTON PEPMITNO. I ✓ <br /> The Undersigned���1Z� T i� 0�,l-� �_T ' <br /> Hereby applies for permission to L(n��- '���rw� �, (l) �,, <br /> � � <br /> At the following locatiun '�� �..t��,��1... _ �� <br /> SKETCH I <br /> �Work to be done) I <br /> � I <br /> 0. . <br /> , � <br /> 0 <br /> � � � <br /> � � <br /> � � I <br /> . � <br /> . <br /> a.s' , 6/09 �� <br /> �� M�I,vo,� `SCAL- E , <br /> P[ACE , <br /> I <br /> ' 1\ ;c�avd ���� b (i..ier <br /> DRWEwAY SECTIOh The undersigned owner herehy agrees to hold .nd � <br /> NO SCaLE savc harm�ess the City of Everetc trom any and;,II �� <br /> f'-- ��s�-----� claims for damages that may arise because of instatla� I <br /> , ('�—,���P tion and maintenance of tL•e improvemer,t h^reto I <br /> � � �—�= applied for and further agrees ro remove same upon <br /> 'i �o'+___ ___._. _.,_�,30' I notice from the City and to replace public property �. <br /> �'1 <br /> �. ��)^ dmwic�ed Ihere y. �� <br /> � i�., � , . u/�/' � <br /> ' Signature of Ap anl ,��p�— i <br /> �/O y' �f. N,!/ � (/ <br /> � COPY OF THIS APPLICATION TO � . Address p __ , ' <br /> � 8E POSTED ON JOBSITE. I t3-��--� �C�G-Q-� - �� <br /> �Telephone Number_ <br /> C�LL [NGWEERING DEPL 259�8871 i� .r} � j J - 'y3/ U � <br /> � I24 HOURti C,CfOR[ CONSTRUCTIONI t ����-j�e Date ��'/ . <br /> � � i <br /> CHECK LIST (�� G ,G Fee ,s �� �_��-i y <br /> Wator Valve �� � ' ept. Approvals ��S c��U <br /> Drainage ' <br /> f,urb&Gutter Engineerg !n �L1 _ � <br /> . Sidewalk Water t ✓�� <br /> /� . /� � <br /> Street �.�-�::'-��.. ?9�>� <br /> �`, r��,�.�� �-Yi�..�,� � '�D ���{ Communicati s �� ` ' <br /> Inspecmr's ignaWre �..�o�%� Treffic � E: ��// � I <br /> Plannin � / _ 7`� S "7¢ , <br /> LS2--� � <br /> �te — ', <br /> Remarks <br /> Note: Original to Cuatomer <br /> 1 Copy to File 1���, g - <br /> 1 Copy to Ins;�ector Approved by <br /> � <br /> Date Approved ��� '/�� <br /> � , <br /> 1 <br /> � <br /> — � <br />