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APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257-8810 <br />Owner Name: ku/ 11,�tosll� <br />Mailing address: 7 Z ©� �p Sfe 141 %eg <br />k1 / 4, a b 7� <br />Phone number: l2�-- Y f7 "/Yf/ <br />Description of Work: teovo <br />Date / / di!-� <br />Applicants Name: If? U <br />Mailing address: <br />1W,w1(-A1v 4�� / R 75- <br />Phone number: /Z ff3 -��/�/ <br />Site Address: M"tVIJ04-7 <br />Comments from Inspector during initial inspection: <br />Approved for Issuance by: Date <br />