Laserfiche WebLink
evereM <br />` APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO. 1�1_aL31;J <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY. <br />n , / i 17 <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION Sill A _ D we 7-Al VF <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />Lj <br />Af( Y- <br />r <br />i <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 />SEWER <br />DRAINAGE <br />WATER <br />DEPARTMENT APPROVALS <br />COMMUNICATION.: <br />TRAErIC -- <br />S C <br />Si UCTION DATE <br />" z/7 mod <br />DRIVEWAY SECTION <br />r30-I-+3 -1 I <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 />e Mpenses, or causes of action that may arise because of installation <br />and memtenenh of the Improvement or other right-of-way use <br />hemto applied to, and hnrier agrees to remove same upon notice <br />trom the City find to replace public property damaged thereby, <br />VLL 6� — <br />gs�2O'►-�"=7 a�E ter-. ir�t <br />ADDRESS i <br />CITY ZIP <br />TELEPHONE NUMBER ALTERNATE <br />