Laserfiche WebLink
rvcrett <br />e <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned –� ►"'t-- <br />Hereby applies for permission to <br />e i z~�4 �, <br />At the following location_� <br />(Work lo be done) <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT I� 02 gl'/� . <br />PERMIT NO.��(--� <br />/ �SD� <br />----E� -t– <br />DFIVEWAY SECTION <br />NO SCALE—_ _ � <br />�--- -- <br />I" UP <br />�30'�_ . ___ . . ._I_30 <br />, <br />-i- <br />i.:�P'( OI- 1H15 i�i'rLICi..� Ilii" l�i <br />�, !.- POSTEU 0�4 JOBSITE I, <br />��_ rticiNr_���wc oerr. ar>s aai i I <br />�.� ;{��I7;;', i C! Of1G Cili::'l P;UCTiOIdI <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />333� <br />qc,pOUGh�- <br />�ouNURy <br />$�DG <br />Ex1sr• 6�� <br />u �'L� � P(ZOP�SEtD GGtJG . SL.AC� <br />� �5 <br />i <br />— — _ � <br />F�AGa o4 ASPM,� ll' _ � <br />3�TH <br />g �'7`/ <br />i _Ct f1L�� ' <br />`t speclor's Signature <br />� 7ypsti <br />���v: � <br />ST <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from . ny and all <br />claims for damages that may arise because ot installa� <br />tion and maintenance oi the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public properry <br />damaged thereby. <br />S�r u Ft� M�- , CQ _— <br />Signature of App icant <br />,�3?n nn� �out:°1 � <br />Address <br />25y-5/3� <br />Telephone Number <br />-' - /�i - 7'S� <br />Da[e <br />12ti�'q Sy <br />�—1 <br />� "�� <br />��SYl1-t��� `T'y il�`�s,�'�'/,��r�' � <br />Remarks �������' �' �f /L� <br />Notc: O�igina toCustomE �T O� �/7 J <br />1CopytoFite � I �!! '._��/ <br />1 Copy to Inspectoi � J <br />i/�Appwved l�y-- `� � <br />Dale Approved � jn /7�, <br />L <br />� <br />