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NOTIFICATIONS: Please include names and mailing addresses of Property Owners in the <br /> block adjacent to the encroachment.For ENCROACHMENTS INTO OPENED OR <br /> UNOPENED ALLEYS. Please include names and mailing addresses of Property Owners in <br /> the block abutting the street or alley right-of-way to be encroached upon <br /> G MI v t c 7. --1E Cis C.12-o4 csi-kart•a-IG 1 <br /> 4L 4,2o•7,c, <br /> Reason for proposed encroachment: <br /> To .k1k 1 to \e.;,_`C 'kA, 1 \ >®;,1w, '\ . . ? 1 'i! <br /> PLEASE NOTE: It can take up to two months to complete the Encroachment Application <br /> process. <br /> Certification: I, EtLt(., 11E k..) c: ,as the applicant for this permit,do <br /> hereby declare that I am the legal owner of the property adjoining the City right-of-way for <br /> which I am requesting use. <br /> Dated this c .tt`-- day of di-V►i-- year dodo <br /> Sig re of Ap.licant(s) <br /> RI kr Date rt()H1'-1c.a. .b <br /> Date <br /> If you have any questions regarding the process of your application contact: <br /> Steven Lange <br /> Engineering Division <br /> 904 6th Street <br /> Anacortes,WA 98221 <br /> Telephone(360)299-198 Fax(360)293-1938 <br /> Please submit complete application with payment to: <br /> Anacortes City Hall <br /> Finance Dept. <br /> Misc Receipts-1301 -2011P Box 547 <br /> th <br /> 020163-0099 Erin WiL..OVA4/ J20 e*M <br /> 1301 Encroachment AgreeMACANN3WA 98221 <br /> Payment Amount: Tekialgte(360)293-1919 Fax(360)293-1938 <br /> Transaction Amount: 100.00 <br /> 03FINDEBIT:********* 1039 <br /> Revised 6/26/2018 <br />