Laserfiche WebLink
APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> everett 10 8 3 3 <br /> f � <br /> CITY ENGINEERS PERMIT NO. , �, � <br /> EVERETT,WASHINGTON <br /> The Undersigned <br /> � <br /> , Hereby applies tor permission to " <br /> At the tollowing location � <br /> SKETCH <br /> (Work to be done) , . , � � • � <br /> I <br /> I /J <br /> I <br /> II <br /> � <br /> II I <br /> DRIVEwAY SEC710N The undersigned owner herehy agrees to hold and <br /> NO SCALE save harmless the City ot Everett from any and all <br /> �_ __ __.� claims for damages[hat may arise because oi installa- <br /> tion and maiirtenance ot the improvement hereto <br /> f� LIP apP��ed (or and turther agrees to remove same upon <br /> l <br /> . 30. _. _ 30 notice i om the City�and m replace publ�e property . <br /> �—�—�— - -�—� damaS�ifieJeby� . . . '�(/f .Q <br /> i � '. . /-i� ✓ � -- <br /> ! i <br /> '� Signature oGAPphcant � <br /> � � 1 <br /> � <br /> �S/' i i�/ t� n — i}/ G '-�� ' � �, <br /> Address <br /> ' �cor�voFiiiisnF�i�ucnnoNio ' -77•1 GG2 7_. <br /> BE POSTED ON J06SIT -L �i Telephone Number ' <br /> CF�1_L ENGINFGFIP:G DEPT. 259-8811 i � - .� ' - �� � <br /> . 1 IiPUIiS L'Ef-OREC COhSlRUClIU�1� Date <br /> � � 2� <br /> Fee <br /> CNECK LIST Dept. ApQrovals <br /> Watxr Valve q/ �� <br /> Drainage � Engineers yY ��'�'`�' '� <br /> Curb&Gutter , . <br /> Sidewalk � � � Water <br /> Strcet <br /> Communications_ — j <br /> Inspeclor's Signature Ti affic �. <br /> Planning — '� <br /> at-�e ----� — �� <br /> Remaiks <br /> Note: Original to Customer � <br /> 1 Ccpv to File 1_f�R'�3 Approved 6y <br /> 1 CoPy to laspector <br /> Date Approved <br />