Laserfiche WebLink
eve.eJt <br />APPLICATION FOR RIGHT-OF-WAY USE <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: �VFv! <br />�7 E p I� CryUA <br />HEREBY APPLIES FOR PERMISSION TO W—y/V"�'T'c!�`� V ✓ U <br />AT THE FOLLOWING LOCATION <br />4- <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-811.11 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />WATER <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS C <br />TRAFFIC <br />PLANNING <br />STREET <br />0 - l/- �� roo <br />AP ROVE FOqCN ' CTIE) <br />DATE <br />1' <br />o <br />AP VED AS CONSTRUCTED <br />---" / <br />DATE <br />Y <br />C <br />NSTRUCTION/AS BUILT <br />l <br />PERMIT <br />PERMIT NO. / <br />DRIVEWAY SECTION <br />f I„ LIP <br />r 30 1- # <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-ol-way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged thereby. <br />CITY zip <br />TELEPHONE NUMBER ALTERNATE <br />/0-1/ - -7q <br />DAT <br />FEE 1978 <br />