|
e � =,:I
<br />everett
<br />A�pLICATION FOR RIGHT-OF-VVAY USE PEr"�iIT
<br />" � Type or pimt clearly with ink
<br />PRESS HAPD - VOU ARE MAKING COPIES
<br />PUBLIC WORKS �
<br />EVERETT, WASHINCTON PERMIT NO. ��� ��
<br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED. IF ANY:
<br />HEREBY APPLIES FOR PERMISSION TO�.se�= �-:'��-� ��� A —
<br />AT THE Pf LLOWING LOCATIGN _ 1� � A�' J SJ /� S�/ S• v" � _
<br />i-1��°
<br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: $/�''
<br />� ; r v ,..+-:'a:+�l
<br />.."��V.�lv►�+�'C1oM �r . .,',� , ' ^ ... 1 .., ��. ...:.. -... 1� , ..
<br />�. � �• 1 ,/ w.y Qp�wrR `�Ow6 db 7�trwiC
<br />�1 I • .G�G,. . Mw4M�0�yt�G 3 r '..
<br />I � �. !X►7f \�n W a AK " . . '. • ' � - �' � � � : �
<br />I • • � S �s. . : ' ': ` � "•' . . �. f 1: .
<br />:"� • 1Nee� .�
<br />. .' dwr�•.. w».s'i:, w�il• 1ee. t e�a��e►Q .ot- ��a.�..ove� a:.� rf,C C ,:: ..
<br />• ,{'.�� �vf.`l�t�9 ,.i.•�M�''�lon . . � �. � .' r : .,. . �. �� • . j �'i .,.
<br />I '. �.. . �'' (� �f• ' ' ' �
<br />.. . • .'' 1 '.' • ' ' � . . k � c�[ 'C'�r' NGw �nVr�+C4, i� NP..i
<br />�. :� '�l. Ew:,�;�,P�:..�.�w�,Y:�.s�oM,�:��O�.w . �L� . . .. _ �/ , . . .. _. .�.
<br />� � GRa-�. ►....s:- {st . :���:� .���i `�
<br />�.� - • ' dr.:►.•�n. s : l�.o.�� % ba ,.�.�.il�= 4l�... ...u...�-::.'
<br />. ` ` �•.. , (� ^ ' /� t ` � ,
<br />. aioio.11�1 ft...eV�JC�w+.`J�.�fC�,�p�.J( ua:''Nt...::dr•.�e.:e:�..,� 1a�or. r.r�
<br />� ���!. � . i � � oe...�i+o'.:'�-..KNock.�aG: OFF oF�- c.nRt��� �a: roe �C. i: �
<br />�, � �,�s.�,�a a���w..� � . _ : ..._. �i :
<br />Al.bw69 .: :. � :. ,� ' I -!
<br />.• „ � ... ��.�io I
<br />.• 3. 4�1 ;saor.c ter•�•w�s•.,.,,s.si-' be snn,..� .e.,.�4� ar ��+a.,r.e.+ o . '�
<br />: : . . ': • n2aice�- Qa. �w..a.o.. �o....%,-. . .. .
<br />' �i�it'._..�: y--=��,•��.- . .
<br />� ,�„_. _. . . . �..�� . � " . �.. . . . . . , ... . - _ . - - - . .. . . . ,,. . . ._ � . .
<br />PEiiMIT IS VALID FOR 60 DAYS
<br />COPY OF THIS APPLICATION TO BE POSTED
<br />ON JOBSITE.
<br />CALL FOR INSPECTION 259-887 1
<br />2� HOURS BEFORE CONSTRUCTION
<br />SEWER
<br />OFAINAGE
<br />DEPHRTMENT APPROVALS
<br />COMMUNiCAtIONS
<br />iRAFFlC
<br />WATER �; I � �'�! ?FA YING� .�i ; J ` --
<br />� , _. .. .. - - - ;—
<br />— �',
<br />S��EET "`
<br />ORIVEWAY SECTION
<br />� --�
<br />r� � I" LIP
<br />�30" I _ 30'�
<br />The undcrsigned, owner �ereby agrees lo hold antl save harmless
<br />Ihe City of Evecett ��nm any enA all claims lor tlnme9es. costs,
<br />eapenses, or causes oi 2:tion ihai may arise because ol insiallation
<br />and maintenance ol Inp ImOwvement or olh?r nghl-e4way use
<br />nereto app�ietl br antl lunhor agrees �o remove same upon nouce
<br />Irom the Uty antl Io re0�ace OubLc proper�y aama9e� t�ervby.
<br />�/✓ //`/'//n �.4s..—
<br />J"'�' /��%�'^.�',. ._
<br />SIGNAiIIRE OF �PPLICAM
<br />G9/(o .ctu�vy�ct� ��
<br />nOD�RE55
<br />F ✓C�'i� �C�l�.i___
<br />
|