Laserfiche WebLink
.�_ �.n. <br />everen <br />Q APPLICATION FOR RIGHT-OF-WaY USF PERMIT <br />� Type or prinl clearly wilh mk <br />_� PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHIN�.:70N PERMIT NO. �a 23 - <br />.. � � <br />APPLICANT (UNDERSIGNED) AND FlFM REPRESENTED, IF ANV: �L��'�' � t�'' �.� -�-'•�— �-'=,�"�• <br />� _, AA .. � _�i _ <br />HEREBV APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION ' ' ' - "' <br />t/Y� n�Y/7 VP <br />DRAWING (WORK TO �E DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COP1/ OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CAL4 FOR INSPECTION 259-881 1� <br />24 HOURS BEFOFiE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />ei,r+����ir���riiir'.rFn -�u�—„L <br />a <br />ORIVEWAY SECTI7N <br />� � <br />� I'� LIP � <br />� <br />f 301�T' —� �1�30"_I <br />T � <br />7�e untlerslpneA�ow� �WrYhy. ayteehlD;hW4,Nd �re �ermless <br />Ine City ol Everett Irom eny end ell ctelme lor tlameges, cosis. <br />e.penses, or causes ol ection Ihet mey arise Ceceuse ol installation <br />antl mau�ir!nanCP d ��e improvemeal Ur Olher nghl-ol-wey u5e <br />herelo applied Inr antl lurihe� agrees lo romove same upon not¢e <br />Irom t�e City an0 lo replace puDbc property tlamaged thereby. <br />y� �� �)� <br />__1�1�(/7"rV �!_i���� <br />SIGNATURE O� r1PPLl Ni <br />i �VZ �C��C �`E • _ <br />nonnes� � /J <br />��i'Uti"� �'/Cv,Jil � S Z v = <br />. .. .ITY � LP <br />2�Z—z��� ' Zs2-2�Ih' <br />TELEPHOlNE NUMBEA /i*EnNniE -- <br />/ _ �"�/�� _ <br />n �� <br />