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213 80TH PL SW 2016-01-01 MF Import
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213 80TH PL SW 2016-01-01 MF Import
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Last modified
4/18/2017 5:10:28 PM
Creation date
4/18/2017 5:10:14 PM
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Template:
Address Document
Street Name
80TH PL SW
Street Number
213
Imported From Microfiche
Yes
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.� <br /> t <br /> .L <br /> be I— <br /> everch <br /> Q APPLICATION FOR FLIGHT-OF-WAY USE PE'AMIT <br /> �j Type or pnut clearly with Ink <br /> PRESS HARD-YOU ARE MAKING COPIES <br /> PUBLIC WORKS <br /> EVERETT,WASHINGTON PERMIT NO.Z9/ <br /> APPLICANT (UNDERSIGNED)AND FIRM REPRESENTED, IF ANY '''��J '�*`�� a1'�• "`^'� �—--- — — <br /> HEREBY APPLIES FOR PERMISSION TO_ -'-� <br /> ._-- <br /> AT THE FOLLOWING LOCATION _. _ 2' 3 BU T H 7� S� w• — — <br /> DRAWING (WOFIK TO BE DONE) OR THREE PLANS ATTACHED: <br /> .r <br /> ORWEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS - .I <br /> COPY OF THIS APPLICATION TO BE POSTED FN� +I" LIP <br /> ON JOBSITE. <br /> CALL FOR INSPECTION 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 /> expenses.or causes of action that may arise because of Installation <br /> eno maintenance of the Improvement or other right-of-way use <br /> hereto applied for and lurther agrees to remove same upon notice <br /> from the G:y and to replace public property damaged thereby, <br /> DEPARTMENT APPROVALS <br /> SEWER COMMUNICATIONS <br /> DRAINAGE TRAriIC , -A <br /> �6-4—Q.1�,t_� <br /> WATER PLANNING SIONATURE OF APPLILANI ✓, <br /> STREET ADDRESS <br /> /'M. (UJB. 9-¢a.-7 3 <br /> / <br /> CITY <br /> r ZIP <br /> V F S U TION !DA �/ �` 3 — V <br /> nn TELEPHONE NUMBER ALTERNATE <br /> — __ rf (•T L IL Pnl[ _ <br />
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