Laserfiche WebLink
everetl <br />, ..e <br />CITY ENGINEERS <br />' EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br />��, The Undersigned \N � i � . , � � � r+ _. <br />� Hereby applies for pertnission to __ �� - 1 �� � "� � A- �� i• u�� �•i <br />At the following <br />(Work to be done) <br />„ <br />� <br />A_ pr,�.l+ <br />i' ,: �•.;� , <br />r <br />c� � � i • G��; .. ` 1-:', <br />' <br />� � <br />' { <br />� ,i <br />!�[ <br />� � <br />DRIVEWAY SECTION <br />NO SCALE <br />� ' �T <br />+1" LIP / I <br />30'�— _--_—_�.3� <br />--�—�--- � — -- � --. __ _. —.__._ . I <br />�COPY Of- THIS APPLICATION TO <br />BE POSTED ON JOBS�TE. <br />CALL ENGINEERING DEPT. 259�8311 <br />�?4 I-IOURS BEFORE CONSTRUCTIOM <br />CHECK LIST <br />Water Vaive <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />� ���r fi�%C-���� - . <br />� Inspector's Signature <br />�� �-� /� 6 <br />Remarks <br />Note: Original to Customer <br />t Copy to File q - �� <br />7 Copy to lnspector <br />J. (.° .? . _ <br />; <br />3a52o <br />PERMITNO. 7�� � <br />-- _ _ _ __ _..-I-- ___ _ <br />� `.'__... <br />, ;- - <br />-� � ; <br />- - �---- <br />. .. . . ... � _ J �� <br />4�� <br />,,, <br />--____ , <br />,, , <br />0 <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of insta�la� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to repiace public property <br />damaged thereby. <br />�y./Atg .-, /f'�'f,..-,.,.- <br />Signature of AppliG6nt <br />,�� e' C. !>�'�....1 .�, r. <br />Address 'r <br />��ti ���! <br />Telephone Numb�r <br />,� �� <br />Date " <br />Fee ` . � 1 , �'� �, <br />Dept. Approvals <br />Engineers � � - �'? � ���' <br />�rf���� �1.�� :,)�t. <br />Water i�li�:. �.i:; ,�.• <br />. Street + <br />Communications <br />Traffic ✓ �� �' '� - <br />Plannin� ' ' � � �% /�--- ^ ; 1 <br />�/�r.� ,.r ;�.� „.,<.�1 <br />� _. JV - �/ :(�fa. v,-.• /.;. %'l. i� 3' _.� <br />r <br />qpproved by <br />Date Approved <br />