Laserfiche WebLink
1 <br />i-_ <br />ev;� <br />Q APPLICATION FOR RIGHT-OF-WAY IiSE PERMIT <br />� Type or p�int cleady with mk <br />� PRESS HARD - YOU ARE MAKING f,OPIES <br />PUBt_IC WORKS <br />EVERcTi, WASHINGTON PERMIT NO. � C3Y� <br />APPLIC,ANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: , <br />HEREBY APPLIES FOR PERMISSION <br />ST <br />!�T THE FOLLOWING LOCATION /2 � 3 2� �• <br />j�✓7�( f'8d <br />DRAWING (WORK TO 8E DONE) OR THREE PLANS ATTACHED: � <br />�� � � <br />L <br />� �� <br />�(� <br />C�% <br />Iv <br />PEF3MIT IS VAI.ID FOR 60 DAYS <br />COPY UF THIS APPLICATION TO BE POSI'ED <br />pIV JOBSITE. <br />CALL FOR lNSPECTION 259-881 1 <br />2A HOURS BEFOHE CONlSTRUCTION <br />ORRINAGE <br />wntF.n <br />DEPARTMENT APPROVALS <br />GOM1IIdUNICAiipfl5 <br />iRAFLIC <br />PLANNING <br />; <br />r � � � i _� .%!� ';�: <br />APPROVED FO CONSTHUCTION�� DarE <br />APPROVED A ON67RUCTE ' � !I.) �^rE <br />� � <br />GON�TRUCTIOidL'��- GUII_T <br />1 <br />DRIVEWAY SEC710N <br />� y� <br />�— ; I" LIP �� <br />� <br />30" �__ _�_30" <br />7he untlersigned ownm hereby aqrees to hota ane save hermless <br />Ihe Cily ol Everell Irom any and nll tlaims lor damn9es. costs. <br />expenses. or causes ol ac6on ihal may arise ber.duse of installation <br />nntl mamtena��ce ol t�e �mprovement o� otne. rig�PnLway use <br />here�o apphc� lor an� luriher amees lo �emove sa�ne upon noucc <br />Irom ine City antl Io replace publ¢ proV��tY h������g�� V�erebY. <br />I <br />SIGNPi Of 4�PliCNNi � <br />�uv 6 f✓�-�--- <br />ao�ness <br />� t<f rl 1.] <br />�„� _ 9_ yr 9/ �>�-' ��' y <br />t6EPr ONE Nu6R3P A� t[nrvnr[ <br />� 7u �u <br />pAif <br />---- ---- -- —_ _ -- <br />� � 7578 <br />