Laserfiche WebLink
f':'j <br />� <br />►'- <br />.; <br />-.. <br />ereren <br />Q APPLICATIOM FOR RIGHT-OF-WAY USE PERMIT <br />♦' Type or pnn� clearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO. �U � <br />APPLICANT �UNDERSIGNED) AND FIRM REPRESENTED, IF ANV: <br />HEREB:' APPLIES FOR PERMISSION TO <br />AT THE FOLLOWING LOCA710N � � / � /���'�"� <br />ORAWiNG (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAVS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 2S9-B61 1 <br />24 HOURS BEFORE CpNSTRUCTION <br />Sf W ER <br />DRAiNRGE <br />WAT[e <br />DEPARTMENT APPROVALS <br />COMMLINiCAii0N5 <br />IRRLiIL <br />PL/.NNING <br />$TRCEi <br />� . <br />f'�� (,t �_ _ � - �( l. J <br />APPROVEDFOR C �STRUCiION DAIE <br />APVROv[o n5 GONSTnUCrEn DR1E <br />DRivEWAr SECTiON <br />I�� LIP <br />L30" � __ �30" <br />r -i- <br />Tnn un0ersignetl owner hereby agrees 10 hold ana save harmless <br />the City ol Everetl Irom any and all claims br d images. cosls. <br />e.penses, or causes ol action Ihal may anse becnus • ol m;tallahon <br />an� mainlenance o� Ihe improvemenl or oiher nuhl�ol�way use <br />nerelo applieE lo� an� lur�ncr ngrres to remove sanie upon nohce <br />Irom Ibe Ctly ana �o replace pu�lic proDotly Aamaged IM1treby. <br />� ���r��.� <br />. �� //V��1/� <br />SIGN4TURE O� RPP�iCFM <br />/�;� ? �On' �i - <br />RDDRE55 <br />>�.� /� <<//;f{ .J . '� 14J <br />air rL� -------- <br />5t'Y- '/71 <br />iEIEPHONE NUMpER A�1[NNRiC <br />� � % -.�'U <br />