Laserfiche WebLink
everett APPLICATION FOR RIGHT-OF-WAY USE PERMIT J 7 <br />Type or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS PERMIT NO. <br />EVERETT, WASHINGTON <br />O <br />�T/ f' <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY:�Y <br />HEREBY APPLIES FOR PERMISSION TO <br />r <br />AT THE FOLLOWING LOCATION <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 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEWER COMMUNICATIONS <br />DRAINAGE TRAFFIC <br />WATER PLANNING <br />STREET <br />A-f COVED 17 CONb I NUt. IIVeI <br />APOVED ASCKKONSSSTRUCIE DATE / <br />;ONSTRUCTION/AS BUILT <br />DRIVEWAY SECTION <br />I" LIP <br />301. _L30„ <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 nght•Of-WPy use <br />hereto applied for and IUrther agrees to remove same upon notice <br />Irom the City and to replace public property damaged thereby. <br />SIGNATURE OF APPLICJINI <br />� o ,Bay 9S8 <br />ADDRESS <br />rr 9dZ 06 <br />CITY 21P <br />1s9- 5/9l <br />i ELEPMONE NUMREN ALTERNATE <br />3 i9-8/ <br />DATE <br />