HomeMy WebLinkAboutROW-2009-0026 - RIGHT OF WAY PERMIT i
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Engineering and Development Services
g,j Y.4y PO Box 547,Anacortes,WA 98221
�. Telephone 360.293.1920
` : Fax 360.293.1938
,.' E-mail enoineerindAcitvofanacortes.org
RIGHT-OF-WAY PERMIT APPLICATION
Submit this application with payment at least five days before the work starts. Please
complete both sides of this form. (City completes shaded sections.)
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LOCATION:
OWNER INFORMATION CONTRACTOR INFORMATION
Name Name L/3'tbo,je & ''i+5 C dlur:li /V/1A
Address /Q 1c( 0 5.4 Address
City A wicA i oa-r e; • City
State ilLA Zip Z Z j State Zip
Telephone S — 1 Telephone
License Number
PROJECT INFORMATION
Work Includes (check all that apply)
❑ Curb Cut ❑Water 0 Sewer •❑ Storm ❑ Gas Sidewalk
❑ Street Cut ❑ Phone ❑ Power ❑ Cable ❑ Culvert
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Work within the City Right-of-Way is permitted by approval of the City Engineer. All work in the right-of-
way must be bonded. The applicant and owner must use warning signs, traffic control, and barricades as
necessary to ensure public safety in the work area. The applicant and owner must restore the right-of-
way to previous condition. The applicant and owner are liable for damage to public and private property.
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