Laserfiche WebLink
everett APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � - _011� _ <br /> ��„�i j ''/_'' ! <br /> CITY ENGINEERS �- ) / ) <br /> EVERETT, WASHINGTON P[RMITNO. v v <br /> The Undersigned SNO/�/1M/SN CDUNTY` -:Y�L/D WASTE n/SRJS�Fi L <br /> Hereby applies for permission to ' <br /> At the follo�ving loca[ion _ �, <br /> SKETCH <br /> (Work to be done) � <br /> �—;UcGi/ ASPNALT D�W �, � <br /> / � <br /> __ _ ; ----- <br /> --- ------ ; � <br /> , � � ' <br /> / �n <br /> / / � w <br /> w <br /> �,� <br /> � <br /> � <br /> -� � <br /> �-�--- � ------, � <br /> �va .scra« � <br /> �� DRNEWA SEC7i0N The undersigned owner hereby agrees to hold and <br /> � NO SCA�E save harmless ihe City of Everett from any and all � � <br /> claims fo•damages i!iat may arise because of installa� . <br /> �, :� :i ''q ; tion arri maintenance of the improvemen[hereto . <br /> � - �� applied for and fi�rther.�o�c�s to remove same upon � <br /> �, 30" ___ 30�� notice from the Ciry and to replace public property � �� <br /> '� damaged therebY• , I <br /> Si�namre of Applicant �i ' <br /> i��ti'Y OF THIS APPLICATION TU � Address � �' <br /> ��'r ;'USTED ON JOBSITE � ' <br /> - Telephone Number � <br /> . �,:U.. CfJGINEERINGDEPT. 259-f3G11 ' � <br /> . a I-IOUP.S L'FFORE CODISTRUC�iIG�!�� Date '� � <br /> . ... _ .__.._— . .. . I <br /> CHECK LIST Fee i <br /> Wacer valve Dept. Approvals ' <br /> Drainage Enyineers � � �- � �- J ��� ' <br /> Cur6&�utter <br /> Sidewalk Water ' <br /> Street _ <br /> Ccmmunications � �� <br /> Inspector's Siynature Traffic <br /> Planning <br /> —bate ---- — — — � <br /> Remarks <br /> � Note: Original to Customer � <br /> , �oPY ta F��E 10117 <br /> 1 Copu to Inspector Approved by , <br /> � Date Approved , <br /> � . <br />