Laserfiche WebLink
�`.�`.� T <br />everett <br />� APPLICATi�N FOR RIGHT-QF-WAY USE PE�IV�IT <br />Type or print clearly with mk <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBIIC WORKS - �n.� a�,r <br />EVERETT, WASHINGTON , PERMIT NO. ���� <br />APPLIC�NT (UNDERSIGNED) AND PIP.M REPRESENTED, IF .4NY: <br />HEREBY APPLIES FOR PERMISSION TO_ <br />AT THE FOLLOWING LOCATION /�720 - ��-� Q%, ,5�� E/�c�'c�`J�� G✓Q /BZOr <br />DRAWIM1'G (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERM17 IS VALID FOEi 60 DAY� <br />COPY OF THIS APPLICATION TO BE Pl7STED <br />ON JOBSITE. <br />CL'1LL FOH IfdSPE�T'ION 259-�8 f 1 <br />24 HOU!�S BEFORE CONSTRUCTION <br />DEPARTMENT APPROVALS <br />SEYIEk <br />onnirvr:,e <br />WATER -- <br />i'• <br />SiREET � , <br />COMMUNiCATIONS <br />TRAFFlC <br />' " PLnNNiNC <br />1 <br />, � �. .� 1 . ' 1' I <br />j ;1 r <br />��'��y7'`' ;. i �o//m/ �o <br />APPROVELF RCOPIS�RUCTIO� —�t�/.TE <br />.j �,/,��`/' � / <br />��i i / /, �;' <br />l _ - ��%�%�� , ��� � <br />,!lY�ROVED.4S CONST� t7LCTE0 / � ��— <br />DRIVEWl+Y SECTION <br />I" LIP <br />I 3n" � � �3ci'� � <br />��-� <br />The untlersigned owner hereby agrees to hoitl and save harmless <br />ihe Cily ol Everett Imm any antl all claims lor tl�mages. rosls. <br />expenses. or causcs of ac�ion ihat may arise tecause o� installaiion <br />an0 mainlenance ol Ihe impwrement or othm nynLoFway use <br />hmsto applietl br and Iurther agrnes �o �emove samc upon notice <br />irom Ihe City and lo replace pubL_ property tlamapetl Ihereby. <br />/,� 1rE,..�=F�t' ��'sr�� � <br />�r' � ��i.• U /C.LI � � <br />S�GNATURE OF PPpL�CANi <br />/�D &�X 4/� _ <br />A�OAE55 <br />Ci//�/G .�' 9��� <br />CqITV / ZIP <br />U�7 ��-t /`-F— _ <br />TELE'^ION[ NU61pER AL`ERNATE <br />On1E �— <br />. . . . . . . � . . . -�... - �. . :.'�� <br />