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APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> , Va ETT i <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 425- 2.57-8810 <br /> Date V I C/ <br /> Owner Name: S ht-LI a: ( Applicant Name: <br /> Mailing Address: -.1:)"-Z,;)-S. 1' pL [Lvt,, Mailing Address: .01013c Le-1st-01w ,4 <br /> tic <br /> nits_ U�IL1 J �,�,t� 1 F038 �s c A 107'16 <br /> Phone Number: Phone Number: <br /> t C -- 477S - <br /> Description of Work: ►'hpn,to r,>, a,,.,f, .:� q- <br /> c,,'ne�..;,�.,� <br /> Loi ) etc-s+') wd( <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: 17 t l 1 'L St ft- <br /> Comments <br /> from Inspector during initial inspection: <br /> Approved for issuance by: Date: <br />