Laserfiche WebLink
everett <br />.. �/ - <br />CITY EhGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned C_ 2r <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br />J C. <br />At the following location .�r�.3 �— .5�� Y`"' .S% _ � ((/, _ <br />(Work [o be <br />� \ <br />; NO SCAL E <br />L <br />�, DRIVEWAY SECTION <br />NO �jSCALE <br />� GS � � <br />�' LIP <br />'�, 30,� � _._-�—�CJ ,-__ --1-3�1 <br />(COPY OF THIS APPLICATION TO I <br />BE POSTED OPl JOBSITE. � <br />� CALL ENGINEERING DEPT. 259�BII11 I, <br />°�1 IiOUHS 3Ef-ORG COiJSTRUCTIOf�.i�i <br />LI <br />i � � <br />-�� ��; %/ . <br />Inspector's SiynaWre <br />� -� .. � t � .� <br />Remarks <br />Note: Original to Customer n c <br />1 Copy to File 1,.1 �, 9 q <br />1 Cop� to inspec[or <br />32 33 <br />�� <br />�j:A,;. <br />� <br />PERMIT <br />1.�196 <br />�•J —V / <br />CONCP,ET� D�hl <br />/NSTfY_L ,NEW /Z " <br />C�/1L"RETE �'ULV,ERT' <br />15' <br />54 r"S� S. 4J <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everezt from any and all � <br />claims for damages that m�y arise because of installa� <br />tion ;and maintenzrr.e of the irnpraaement hereto <br />applied for and turther agrees to remol�e same upon <br />notice from the City 2nd to replace pub�l' �property <br />dam�d�h e6y. �� �c G/ , <br />� �� <br />ign ure of Applicant ��T� � <br />-�/'C� / — ���� �-"- S, l�/ ��,� ;:..h` <br />Add�ess <br />_�5 �'� — �� � �� � � <br />Telephone Number , <br />--��— � .� <br />Date <br />/a. Sll -� �� � 1' <br />Fee <br />Approv SJ by ' j'. . <br />,�.c:%�,' � � �i� s .-�. ��� l `� ,�S_ <br />Date Aoprov d <br />