Laserfiche WebLink
tVefe„ APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />� TYPe or print cleady with mk <br />PRESS H�RD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF <br />HEREBV APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOCATION � � 2 9 W Q�I S! <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERA�IT NO._G;�(- <br />PERMIT !S VALID FOR 6i* DA�IS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR IPiSPECTiON 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />sEwEn <br />DRRINnGE <br />WATER <br />STPEET <br />DEPARTMENT APPROVALS <br />COMMUNIGTION$ <br />iRPFtIC. <br />PIANNMG <br />AVPROVE�FO� CONti1RUCTION 0/•« <br />'•— p AS CONSTRUCTED �A�E <br />DRIVEWAY SECTION <br />j I" LIP � <br />30'� �j�30" I <br />i 1 <br />T�e unAerSigneU owncr horeby egrees to hole nnC save ha�mless <br />the Cily of Everetl Imm any antl all clpims �or Eemxges. costs. <br />CRpCn5C5. O! C0u5C5 0� BCIIOO IhO� TBy 6fI5C �¢C005C 01105Ip118110n <br />3nd mamlenance al Ihe improvemenl or olher ngN-obway u5e <br />herelo aOPbeA IOt an� Iuriher �c�rees lo removC SAme upon not¢e <br />Imm Ine Ctly a�C lo repince pu�l�c pmperly tlamageE Ihereby <br />_�� ` � <br />, ,,:ATURE OF Av IC4N1 <br />.� � � C� ����k�� <br />AODRE55 <br />�.,�,,��.t�� � i /n, . 9 YZ c � <br />pi� bv <br />.".59-6��_ <br />tELEPMONC NUMBER AL1EfiNAiE <br />197A <br />