Laserfiche WebLink
r L.[ <br /> Y <br />,r <br /> I <br /> I <br /> f!V!ElII ` <br /> APPLIC#1 .7ION FOR RIGHT'-OF-WAY U&E PERMIT <br /> Type or print clearly with Ink <br /> FRESS HARD- YOU ARE MAKING COPIES <br /> PUBLIC WORKSJ <br /> EVERETT,WASHINGTON PERIUII NO. -J <br /> APPLICANT (UNDERSIGNED) !.Nr .AM REPRESENTED,IF ANY: <br /> VIER%'APPLIES FOR PERMISSION TO a° " <br /> AT THE r 1h LOWING LOCATION_ 30/ 8o T~ n/, s, W, <br /> DRAWING (WO- K TO BE DONE) OR THREE PLANS ATTACHED: <br /> I <br /> VJ cam• /H^ r - �!J Vl{/l ate <br /> I <br /> I <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS <br /> COPY OF THIS APPLICATION TO BE POSTED I" LIP <br /> ON JOBSITE. 30- f I O I <br /> CALL FOR INSPE1T11" 2591-861 1 '1•-�1 <br /> 24 HOURS BEFORE CONSTRUCTION The undemAgned owner hereby agrees to hold and save herWess <br /> the City of Everett from any and aR claims for damages, coon. <br /> Bapnnaes.or causes of action that may arise bbCeuse of inslallabdn <br /> and maintenance of the Improvem<ot or other right-of-way use <br /> hereto applied for and lunar agreeu to remove same upon nouco <br /> from In" CITY and to reply Le public proDsny damaged thereby. <br /> DEPARTMENT APPROVALS <br /> i <br /> SEWER COMMUNICATIONS <br /> DRAINAGE TRAFFIC Q <br /> WATER PLANNING SIGNATURE O- E APKICAN/VI <br /> ADDRESS <br /> LV <br /> CITY 7 ,L ZIP <br /> DATE TELEPHONE NUMBER ALTERNATE <br /> STRUCTED pnv <br />