No. _________


                                                                                                                    (200____)

 APPLICANT - Individual

Name______________________________________________  Phone No.______________

Address___________________________________________

City___________________

County________________State_________Zip_____________

                                

 APPLICANT - Corporation ***

Local Office__________________________________

Agent_______________________

Address_______________________________________ Phone No.___________________

City___________________  County________________ State________

Zip___________

Headquarter Office____________________________

Manager_____________________ 

Address____________________________________________________________________

City___________________  County________________ State________

Zip___________

I hereby apply for an easement on the portion of the City-owned property as illustrated on 
page two for the following purpose(s):

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Legal description of property:___________________________________________________ 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Located in Section_________, Township___________,

Range____________E., W.M.

Enclosed is my check for the initial administrative fee of $100.00 to establish the requested 
easement. Make checks payable to Seattle City Light.

This administrative fee will be returned if this application is denied by Seattle City Light.

I understand that in addition, if the application is approved, a fee based upon the fair market 
value of the easement area will be charged For this easement, plus any applicable state, county, 
or city taxes.


Signed______________________________________ Dated__________________________
          (Applicant)


VICINITY MAP AND LOCATION OF PROPOSED EASEMENT AREA  Scale____________
(Please show streets, buildings, fences, or other features which relate to your request.)