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4 77TH PL SW 2016-01-01 MF Import
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4 77TH PL SW 2016-01-01 MF Import
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Last modified
4/18/2017 1:05:09 PM
Creation date
4/18/2017 1:05:04 PM
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Template:
Address Document
Street Name
77TH PL SW
Street Number
4
Imported From Microfiche
Yes
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I <br /> CyE rC„1 <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or print clearly with Ink <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS <br /> EVERETT,WASHINGTON PERMIT NO. LL- <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED, IF ANY-____._ <br /> HEREBY APPLIES FOR PERMISSION TO p _ <br /> AT THE FOLLOWING LOCATION `7� Zr�Ak, S� <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS <br /> COPY OF THIS APPLICATION TO BE POSTED + I” LIP <br /> ON JOBSITE. 3011 � 3011 <br /> CALL FOR INSPECTIO14 259-881 1 <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and save harmless <br /> The City of Everett from any and all claims for damages, costs. <br /> eaponsea.or causes of action That may arise because of Installation <br /> end mamlenance of The Improvement or other tight of-way use <br /> horeto applied for and further agrees to remove same upon notice <br /> frim the City and To replace public property damaged thereby. <br /> DEPARTMENT APPROVALS <br /> SEW-Ft COMMUNICATIONS <br /> DRAINAGE TRAFFIC <br /> WATER PLANNING "DiShIlmE OF APPLICANT <br /> X013 <br /> SinEEt AODRFSS <br /> - Pfire IIP <br />
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