Laserfiche WebLink
� � :,'i�r�(o!� <br />cveretl <br />� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly wnh ink <br />PRESS HAFC - YOU ARE MAKING COf'IES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERAAIT NO. �t7 <br />APPLICANT (UNDERSIGNED) AND FI <br />i HEREBY APPLIES FOH PERMISSION <br />AT THE FOLLOWING LOCATION <br />17.21 lJ,r,�,��<< <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />Rooi' o�e�1..nn\ �7 �,•oE �v cxie...c� o.+er <br />nr.�oer�... 1��e <br />PERMIT IS VALID FOR 60 �1AVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />i:ALL FOR �NSPECTION 259-�87 1 <br />24 HOURS BEFORE CONSTRUCTION <br />� '/i�?"'�' y� � . <br />! .�r '1_' I L� . _i <br />`� .� ' . ' ;. . l �'. ( (, <br />DEPARTMENT APPROVAL��I <br />;�C , .�` i <br />�.....,. <br />..._... <br />SEWEN ' '' � CO1AMlINICAT�ONS <br />;.;'3ifi,t, l� =��,. � ....�. <br />DRAINAGE � t��iqlu ' RAFf�L <br />1 �, , <br />, n.�. . <br />1YqTEN �LRNNING <br />StREET <br />�-��.��- �� �- �, <br />ROVEU FOR CONSTqUGTION � DAiL <br />� �,`�. tiv � � � � <br />A WEO AS C N�RUCTED • C <br />CON�fRI1CTION!�S pUILT <br />ORIVEWAY SECTION <br />� � <br />I�� LIP <br />�30„ T - �_30,� <br />The untlersignr0 owner �ere0y agrees to hola and swve hermless <br />Ihe Qty ol Everet! Imm any antl nll claims tor Gameges. cosls, <br />eapenses. or cavses ol aciion Ihat may anse because ol ins:allabon <br />antl mamtenance ol the �mp�ove�ent or other ngh4oi�way ose <br />M1erelo anv��ed 1or antl 4rtlher agrees to remove same upon not¢e <br />Irom Ine Qiv ar.a Io repiace O��biic propei�Y 4ama�e0 Inereby. <br />; <br />� . [ i�_c C.�n e � <br />SIGNRIURE OF PC�ICANi , I � <br />70l V (/1_ ,.f'l.i.�C/ ' <br />RDOH[5: <br />ae��Z� /c- �/8�/ <br />cirv � ziv �OA�R-' I�HeI.!g <br />a5��' - y7so _ �s��- � �>s <br />TELF.PNONE NUMBEN /L1ERN/.iE <br />DAIE <br />L/ _ � � _ � / _ _ <br />1978 <br />e� <br />