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APPLICATION fo!' <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425-257-8810 <br />owner Name: --� � �� �"`L <br />Mailing Address: 7 ( ! �"S � � S � <br />��c` i �'� l�� 1 ��� <br />i��„� 6qll� ,-, <br />Pw w � zo� -o� � <br />Date �� �/ L <br />Applicant Name: � �'�^4U� r�►�'� ` l��jTi'�'r-Aa�, <br />l,�c <br />MailingAddress: ,L�II�i ��r'f'�'1 i��c�.%L�rtinCJ'Y� <br />J <br />� ��� e ���(s� c,�.��lY1��s--z <br />Phone rdumber. `�,�� ,1� 1 j 7.C�� Phone Number. �/„ZS 3yS ,�2/ /,� <br />/ - . -J ' j , � i '}. <br />, I <br />I, �I, �. ���rll c� c�'�►✓� �,� �� s�� ��•� f <br />Descrlption of Work: -���jj�,� �- <br />(.'.LL�K� ti"`� �'�� �� L c W�-• ��C� C� J l trt .1-.� l{.R �i L. <br />Site� Address: <br />(� drawing or plans may be needed to illuslrate work to be done� <br />% 7'S �" S�'j" S C �JY'�'c'S.' � <<J/� <br />Comments trom Inspector during Initial Inspectlon: .J. <br />Wtl� QION{� 7/ �SfiS� Td' 41 /C'Qf� <br />1��Q�ce qrra .S�tqll exfe�,J � t 4 f e� � <br />��e� �n� t�o��� dri�Gk/a y �w at �t4f r PoS�'�� �"" � <br />Sout�+ �Jt co•wW of fcNce.. r " I � <br />�1 J f[� q nr�� af wvn���� 7✓n�, �A ciCoV'L 1"0� W0.�j <br />'_l:)� aI�iGC .S"�4�� be J�/a OI- / <br />�O /U� �1 �Py`�. <br />Approved for Issuance by: _ Date: <br />