Laserfiche WebLink
evrreti <br />e <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT•OF-WAY USE PERYIIT <br />�.o4zs ,U <br />!'i.��, / <br />�' � �v� <br />PERMIT N0. � � � �. '= !, � <br />The l;ndersigned ..�� r b� I'� L. /"l c� � r C�'� � <br />Hereby applies for permission to i n n s f r u � f C / 7� ������ (j� �l.y. y� �------�� <br />i <br />�F�+ti1, ✓ �� <br />At the following location__ S3 0�. "� �'? n d,.o �. �. �>. ,...,._� . � <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />i •- I 7 ' --- � <br />�" LIP <br />� 0 �___.—_—_-- .___�30�� <br />------- —_..____. _ .._. <br />;OPY OF TfiIS i1PPLICFlTIOfd TO � <br />!3E FOSTED ON JOBSITE. I <br />CALL ENGINE[RING DEPT. 259-3£tt i <br />24 I-IpURS E:Ef�C1RL t:�!dti i-��UCI-Ir�i: <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />d <br />1''��a <br />1Aas t"j �,.,� . <br />.,A�. k. af .: f:� , . <br />In'spector s �gna[ure <br />��''t° �'��� <br />—date � ,�y� <br />�i i8 �a+ �'�.'""c."'j�+a"`� '-J?.•,,o, �t. <br />.a �f _ : i � f_.a f <br />Remarks <br />Nnte: Oriyinal [o Customer <br />,�°PYt°F�'� 10423 <br />1 Copy ro Inspecto� <br />ti� <br />FF;s7ir <br />i2" cu <br />Noi to S�Q(P <br />���i.�=�f-..��,e...� 4�5�76 <br />V <br />� <br />,,, <br />> <br />� <br />ry <br />,� <br />� <br />� <br />/ <br />E <br />, <br />_�' ; <br />� <br />_� <br />--�- � 1 <br />r <br />t <br />� a� � T <br />�rt' _ 1� <br />< I �: <br />R.O.�^i. <br />The undersigned owner hereby a9rees to hold and <br />save harmless the Ci:y of Evcrett from any and all <br />claims for c�amages tliat may arise because oi installa� <br />tion and m�iintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby. <br />__5����•3-�s ln,�,�- <br />Signature of App%icant y,Y 2-: [„ <br />i�h S%„f'_.�`'_(. F_�.e�ec}i IAini <br />Address <br />3SS- :Ss�y <br />Telephone Number — <br />__._ �. �, �� , ��— <br />Fer. � <br />Dept A pr va <br />`� �-' �y � � EngineeDrs A� (� <br />Water /IL - /v(e���sC C (�-R✓,� <br />�� <br />S: eet���Y ,. <br />Commum;ations <br />i <br />Traffic„ � � � � <br />Plamm�g.s � / <br />SPwCi /� �_ Tho �tS� /�}-/�7 <br />,; <br />AnPr--F� �.�..�� <br />�� <br />Date Appra-ecf � <br />