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• • <br /> tu c,--) I O�094 <br /> APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> PUBLIC WORKS DEPARTMENT <br /> .ETT <br /> 3200 Cedar Street <br /> Everett, WA 98201 425 - 2.57-8810 <br /> Date <br /> Owner Name: 5VEi?f77 )/OU5/.D6 A i7/�Dr lYApplicant Name: 11- V/1,‘,3w I►iX I <br /> Mailing Address: 3/p 7 Ce,A y Mailing Address: SES()7 <br /> ,uc/?c7T/ 4//9 26920 <br /> Phone Number: 1124- 38 -110/6 Phone Number: S74-/rte <br /> Description of Work: Cu ;j cul 5 2v/CL 7-27-150c-1 /3 G . <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> f91kGi LtetLcr <br /> Site Address: �� o OP ' = ' <br /> Comments from Inspector during initial inspection: <br /> Approved for issuance by: Date: <br />