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11 77TH ST SE 2016-01-01 MF Import
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11 77TH ST SE 2016-01-01 MF Import
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Last modified
4/18/2017 1:23:45 PM
Creation date
4/18/2017 1:23:40 PM
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Template:
Address Document
Street Name
77TH ST SE
Street Number
11
Imported From Microfiche
Yes
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J , <br /> ' 4 <br /> rvrrrtt <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or print clearly oath Ink <br /> PRESS HARD -YOU ARE MAKING COPIES <br /> PUBLIC WORKS <br /> EVERETT,WASHINGTON PERMIT NO. <br /> APPLICANT IUNDERSIGNEDI AND FIRM REPRESENTED, IF ANY: <br /> HEREBY APPLIES FOR PERMISSION TO - <br /> AT THE FOLLOWING LOCATION _. �� ��7 ------ <br /> J q�6-ss <br /> DRAWING (WORK TO BE DONE) OR THRE: PLANS ATTACHED: 9 <br /> -_� DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS <br /> COPY OF THIS APPLICATION TO BE POSTED <br /> ON JOBSITE. <br /> CALL FOR INISPECTiON 759-881 1 •T� '—� 'I`"1 <br /> 24 HOURS 13EFORE CONSTRUCTION The undersigned owner hereby agrees to hold and save harmless <br /> the City of Everelt from any and all claims for damages. costa. <br /> expenses,or causes of action that may ansa because of InalallabO,i <br /> end maintenance of the Improvement or other right-cf-way use <br /> hereto applied lot and further agrees to remove tame upon nul.ce <br /> from the City and to replace public property damaged then•by <br /> DEPARTMENT APPROVALS <br /> SEWER -COMMUNICATIONS <br /> DRAINAGE TRA FFIC <br /> �f1lfi�srr r c E y��s i, �.�✓; r•�rc <br /> - r--- ' ;�` 'f•E,cAr �(,� �!.r� ., � % -- <br /> WATER _ PIANN�NG i IONAtURE OF APPLICANT <br /> STREET ..___y.Y . __ DRC-/%, <br /> CITY IP <br /> 2%-APli " j <br /> R V D R I DATE "I <br /> TELEPHONE <br /> NUMBER ALTERNATE <br /> 7-/ -E <br /> AnPFIOVFn A$ ,0N5Tf11!OTFD - -- DATE DATE <br />
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