Laserfiche WebLink
�everen <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPI.1CqTION FOR RIGHT•OF•YJAY USE PERMI"f <br />�' ���4� <br />PERMITNO._ %7— /S?i� <br />�-. <br />The Undersigned � � •� � i' , �:' ,Q N'TNP i �/ <br />Hereby applies for permission to r" —"" d �— �� <br />At the following location ��/_ � 1d�;=„ �� .',~ <br />(Work to be done) <br />5��- <br />z <br />�RIVEWAY SECTION <br />NO SCALE <br />r--- --- -�, <br />�_ �I"lIP � <br />(,.3��.1.. _ . ._. . _ . __ I 30 I <br />i �. . � <br />� �i'Y OF THIS APPLICP.TIOP! TO <br />' ' i�OSTED ON JO�SITE. I <br />CN. ,. ENG�IdFf FiING DEPT. 259-Si311 � <br />�?4 iltiU�;S i;Lf-OR[ CONSTRUCTION�I <br />CHECK LIST <br />Water Valve <br />Drainaye <br />Curb & Gutter <br />Sidewalk � <br />�,u /:�� , .. ,- <br />Inspecmr's Signature <br />Note: Original to Customer <br />� 1 Copy in Fle �� n�� <br />1 Copy to Inspecto� � <br />/'� / / r�C/if� i� <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett irom any and all <br />claims inr Aamages that may arise because of installa� <br />tion and maintenance oi ihe improvement hereto <br />applied tor and further agrees m remove same upon <br />notice m the City and place pubiic property <br />age I•�re <br />._a_y% ' <br />Sig,�n �urYof Applicant -- <br />n� 52 � � �'a r,�1 Au�l�— <br />Te e�.��_.�,�...,���,� <br />m er — <br />Dat� �'�� <br />� <br />i <br />Fee <br />/ � s � '_�� <br />Dept. Approvals <br />/ <br />Engineers_._.��� ��v , <br />��y Street <br />Communications <br />Planning_. <br />Approved by <br />Datc APP�oved <br />