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APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 .425 •:2.57-8810 <br />Date <br />OwnerName: Applicant Name: <br />Mailing Address: �O l/% Mailing Address: Z%/7 (&,Vr 0,W A <br />Phone Number: zs, JG/ �L�`�SC Phone Number: ZVZS ,S�f7 39Z?, <br />Description of Work: <br />(A drawing or plans may be needed to illustrate work to be done) <br />Site Address:�1 <br />Comments from Inspector during initial inspection: <br />DC�0�1� <br />MAY 2 6 2010 <br />CITY OF EVERETT <br />Permit Services <br />Approved for issuance by: Date: <br />