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APPLICATION for - <br />PUBLIC WORKS PERMIT. <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 9R201 (425) 257-8810 <br />Date <br />Owner Name: ("JV- o� <br />Mailing address: P-c. &C - Fit4�—, <br />Applicants Name: <br />Mailing address: <br />LIB - cSzcy e C.�✓-� `!,�'Zrc�r <br />Phone number: qZ)- ��� = t �C� `� Phone number. <br />Description of Work: <br />Site Address: L%� d 9- d Ly ia(c.. 0/.(_ <br />Comments from Inspector during initial inspection: <br />Approved for Issuance by: Date <br />a <br />