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Owner Name: <br />APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425»:257-8810 <br />ch riS Johns) n Applicant Name <br />Mailing Address: q-1 SeahW(St VC Mailing Address: <br />Phone Number: `�t25' I�(� 2, 2. Phone Number: <br />Date 12 d l <br />(-.Sck YVIC) <br />Description of Work: Subd V 1—�sl On O� 1®A 1 n <br />On ac.,re.�, G <br />(A drawing or plans may be needed to illustrate work to be done) <br />Site Address: "A-7 2--1 S)eahuf Ar q— . Euae,-t+, u o ft �IO o- 6 `? <br />Comments from Inspector during initial inspection: <br />Approved for issuance by: Date: <br />