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5017 23RD AVE W 2016-01-01 MF Import
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5017 23RD AVE W 2016-01-01 MF Import
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Last modified
4/1/2017 8:45:01 AM
Creation date
4/1/2017 8:44:55 AM
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Template:
Address Document
Street Name
23RD AVE W
Street Number
5017
Imported From Microfiche
Yes
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r��«n � <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> �10646 <br /> � <br /> CITY ENGINEEH� � , __ � � :�_ <br /> EVERETT, WASHINGTON PERMITNO. � � -� _ <br /> The Undersigned y�-�- - Y __�� <br /> Hereby applies for permission ro � ��;� �� .-- t „� � < --.,. .,:t � h��.i _ <br /> At the following location -`>�- Z 5 '^~' r �� �_.• ��.� <br /> SKETCFI — -- — i � — <br /> (Work to be done) ;��; i I I <br /> �I-- . �`' "X I ._ .I <br /> � h'- �.�- - <br /> �� �,�' i <br /> � ���� � ; <br /> � � , <br /> , � <br /> � ; ' <br /> I 4� � � � <br /> i � <br /> I �. �1 I <br /> I � <br /> -� � /� <br /> i---��--��_ ei � � . <br /> i � <br /> � �� � �. i <br /> � ---- ---��:1--T'� W� ��\ <br /> � � -- - - - 1 fi -- <br /> i �, ;�- ,-��.�,��� ; � <br /> � �,� ���r �n <br /> ! } ,i � � � <br /> �� .i�� ['`' ' , :.f'�I �l J j� I <br /> I . sV � . �Vv W � <br /> � ����� ( � � <br /> ;.� > � _� _,- I <br /> � ;.,, � � <br /> ------- -—�-+----r'; <br /> �,--: - <br /> ORIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> 40 SCALE save hannless the Ciry of Everett from any and all <br /> � claims for damages that may arise because of in;talla� <br /> F-------- I <br /> +� L�P -�1 [ion and maintenance of the improvement hereto <br /> applied for�nd fu�ther tqrees to remove same upon <br /> F,30",I . _ _.. . I 30"�; notice Trom the City and to replace public property <br /> damaged t ereby. <br /> ������ �� <br /> Signawre of Applicant T� <br /> --,!'�-3v�g--/��`''-�--�,—., <br /> �� COFYO� TfiIS �\fPLIC;A�IiiPJ1U �� Address -, i :. .- i: -. • � . . � ,' -. ��- <br /> �� BE POSTFD ON JOBSITE. I 7�ej� � S ?d <br /> Telephone Number <br /> I C,1LL f-tdGli.!rERIf�iG DEPT. 259�8817 � <br /> I�, i�t IIOU��B Bi=FOiaE CON;iiRi1CTIOPI� Date � . <br /> , - <br /> . . .. ... . . . ; , .:- ' � <br /> CHECK LfST Fee <br /> Water Valve Dept. Approvals <br /> Drainage ,� <br /> C�rb & Gutter Engineers_���✓'� .r � � <br /> Sidewalk Watc�l�n. •C��-r�_(v!E-'-1��� 'LIAc- 1112�-i1 <br /> /{ � T <br /> Stree[ •I�� . ( .l i�.' f <br /> — -- _-.. . ..--. ___. . —_. <br /> Communications ��� ," ..-��-- 1.�. .. .� ,.- !. i-� r <br /> Inspectur's Si;ratum Traffic <br /> Planning <br /> / � , -; <br /> . <br /> ---- - - _ . .___. . .. . ----- .. , -�: . ' <br /> -15ote * , <br /> Remarks <br /> Note: Original to Custui�er <br /> , co�v to r-�i� �_ n�f� �j — — <br /> 1 Copy to Inspector Approved by <br /> Llate Approved � <br />
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