Application To Perform Work On City Road Right-Of-Way Form - City Of Westport Page 3

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_________
Permit No.
CITY OF WESTPORT
PO Box 505
Westport, WA 98595
Phone: 360-268-0835 Fax: 360-268-0921
APPLICATION TO PERFORM WORK ON CITY ROAD RIGHT-OF-WAY
Location of Work (attach map): ____________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Description of Work: _____________________________________________________________________________
Drawings attached: Yes _______ No _______
Form updated 6/2009

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