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5111 23RD AVE W 2016-01-01 MF Import
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5111 23RD AVE W 2016-01-01 MF Import
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Last modified
4/1/2017 8:56:24 AM
Creation date
4/1/2017 8:56:19 AM
Metadata
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Template:
Address Document
Street Name
23RD AVE W
Street Number
5111
Imported From Microfiche
Yes
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`--' APPUCATION FOR RiGHT-OF WAY USE PERMIT � 13$O <br /> everetl <br /> ' � , <br /> �ITY ENGINEERS PEHMIT NO. �8 —274 <br /> EVCRETT, NlASHINGTON <br /> The Undersigned_�L��/_/L�=�`�L- (/'�'/!,i .��-f��'� <br /> flerebyappliesforpermissionto �-1����-� 7 L��? �Z— ���� <br /> � 3 a� <br /> At the following Ixa•io❑ �� � � � z ���" U <br /> SKETCH <br /> !Wark to be done) � <br /> —L - <br /> �j� l-O �Ch,`L (.� <br /> '�O�.f/�' i O'/�'/�_"3 <br /> DRIVEWAY SECTICN The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmicss the City of Everet[from any and all <br /> t� � claims for damages tha[may arise because of installa- <br /> � tion and mair�tenance of the improvement hereto <br /> I" LiP applied for and further agrees t emove same upon <br /> �30" 30� no[i _ rom the City and to r lacqpublic pro erty <br /> � � et�thereby. � <br /> 7 XfC <br /> Sighat pplic n <br /> CO°!' OF 7HIS APPLICATION TO Address ���2. ,i`� (�Ilc,j 7 <br /> BE POSTEO ON JOBSITE. ����j <br /> Tel phone Number <br /> CALL ENGIN9ERING DEPT. 259-R817 � �� /—� 3,� � � <br /> 24 HOURS BEFORE CONSTRUCT�O� Date � <br /> — ---- / �� � �� G <br /> CHECK LIST �f-ee <br /> Water Valve DBpt. Approval5 <br /> Dreina9a <br /> Curb &Gutter Engineers <br /> Sidewalk Water <br /> Stree[ _ <br /> Commun ica[ions_. <br /> Inspector'sSignature Traffic _ <br /> Planning _ __. <br /> �a[e <br /> Remarks 1 � � p (1 <br /> lJ U <br /> ' ' Approved by <br /> C�sToh7ER Date Approved . � <br /> y <br />
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