Laserfiche WebLink
r- <br />L <br />L <br />everetl <br />Q APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />�j Type or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS �0 O <br />PERMIT NO. <br />EVERETT. WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY: Cobra Construction Company_ <br />HEREBY APPLIES FOR PERMISSION TO rework esistina grives and w3&ks per plans <br />and specifications of <br />A'. THE FOLLOWING LOCATION 1717 Califprnia Everett <br />DRAWING (aNORK TO BE DONE) OR THREE PLANS ATTACHED: <br />T�F� <br />PERMIT IS VALID <br />O DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 239-881 1 <br />24 HOURS BEFORE CONSTRUCTIIIN <br />\ . <br />T <br />DRIVEWAY SECTION <br />j1' LIP <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-of-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 />SIGNATURE OF APPLICANt <br />P. O. Box 1299 <br />ADDRESS <br />Everett WA 98201 <br />CITY ZIP <br />(206) 25R=3-6- 7 <br />TELEPHONE NUMBER ALi ERNATE <br />CONSTRUCTION/AS BUILT <br />