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• <br /> + Eng,neenng nnri Development Sei\w <br /> 'PO Faux 547 A1)a001t0,WA g$221 <br /> Telephone 360,203IVO <br /> P C coX a6D,2,p31p3n <br /> _mail en4ineennmaitilyrganar orres orq <br /> • RIGHT-OF-WAY PERMIT FRANCHISE APPLICATION <br /> Submit this •application a.t•least five days before the •wafli starts Pfease complete <br /> bO#h sides of this form. <br /> SITe PERMIT <br /> GAGATION: 29Jd/ U NUMBER; R - 2O( I — 0015 <br /> C'RANPH SE INFORMATION CONTRACTOR INFGR ,, TWDN <br /> Company Wads Gast l,e t -f v ( (04,5 Name , <br /> • Mailing Address j w S )w 5.1-- Address bi.72 5./i G fAV8[fli <br /> ' City,'State,Zip (Ularnnf" IleivtoA to)IR-c15?-73 •Pity . {ilk - - <br /> Telephone C�c�U) 33ta-(alS(o , , State WA Zip , g.d, 3 • <br /> Fax ('_,tao) 3tr�`2. 10L1 Telephone. (zas} y y�7,3�JgH <br /> Contract Name CJ eA License Number <br /> PROJECT 1NPORMA71ON , <br /> Wort[Includes(cheek all thai apply) <br /> 0 Curb Cut 0 Water 0 sewer O'Storm 14Gas 0•Sidevdalli <br /> ❑Steel Cuf ❑Phone fl Power D Cable , 0 Culver 0 Outside the Traveled Way , <br /> • Describe Work, ,27?374./J nely�t vice /;- e- i hi <br /> 4- v <br /> , f Adilress• AY/elf vr_x: Uc xs'' f// Ifr,/e.%11,2rae. / ' • <br /> !t/,' r' ti • cS . <br /> PERMIT TYPE <br /> 0 Curb Cut 5O Ej Strea Cut$ 1i 0 Inside Tradeldd Way.$b0 0 Outside Traveled Way,.$20 <br /> 'PECI'AL. REQUIFtEME.UTS: . G`al/1.8(IO.40. 55,5 two huSinOs .daysbefare you dig: <br /> I <br /> Work within the CRY f Way is perrnitted by approval of the Oily Engineer. All Orli In the light-of <br /> way must be banded The epplllbant and owner w‘sming signs,traffic control,and barricades as <br /> necessary to ensure publle safety in-the work area. The applidant and owner must testare.the right-0- <br /> . <br /> way to previous cnndltion, The applicant:and owner are/lable'for rawhide to public.end private praperty, <br /> ,7-1_ " ? 2f/ 1 /k//7 <br /> l / <br /> G !A ti lion rovai St nature f Dale A plicant Sl n'alur Date <br /> PP AFA. 8 P � <br />