Laserfiche WebLink
A <br />L <br />N <br />rveren <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with IT <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHING rON <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: -.AL— j iS C O/9 S L� <br />NFRFRV ADDI IFC FfIR PERMISSION TO—LaLY_LJ <br />AT THE FOLLOWING LOCATION <br />DRAWI <br />p' <br />�. <br />il�re/e- <br />pcle �7161e 3v,Qppr rt <br />Y <br />/. Prop. /oo' X 3"0' <br />x r5f %uq - /-lo rn e, t ele ph one p&les, <br />n fc.p Ile/eG Ai.L2y F .°-f7[P fS, ro cG Pd <br />:,�rociyrC L,,. i; G'C IPEr.•nf: n5 �.Ax L. <br />--- /00'- <br />. ex c I .,. ... Dill! rF . , W,-/.- <br />PERMIT IS VALID FOR 60 DAYS <br />PERMIT NO.2 li <br />SHALL SC LN %dC(�'kD4rtC� <br />awTfl IS4A/00 of /aJO'THEA.l i <br />r�I/+UUTrS 0/1-7LF67 Z -8 / i <br />DRIVEWAY TION <br />COPY OF THIS APPLICATION TO BE POSTED I" LIP <br />ON JOBSITE. 130", �— 30" <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and save harmless <br />DEPARTMENT APPROVALS <br />SEWER <br />DRAINAGE <br />WATER PLANNING <br />the City of Everett from any and all claims for damages. costs. <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-ol-Way use <br />hereto ap II-d for d further agrees to remove same u on notice <br />from ITTC an /to replace Pablo property nnmag d1 Tby. <br />91GNATURE OF APPLICANL ' <br />ADDRESS <br />eye W h 2 S :Io3 <br />`3s�-ys„3 ZP yi�E <br />TELEPHONE NUMBER ALTERNATE <br />PATE <br />I <br />FEE �9%8 <br />CONS-AUCTION/AS BUILT <br />