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APPLICATION for <br /> h PUBLIC WORKS PERMIT <br /> v. PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 425- 257-8810 <br /> Date <br /> ,, k5lV> 5#AMz0e1c <br /> Owner Name: 5-#Ae oet IA,4-1 int,',,$ Applicant Name: <br /> Mailing Address: 1 o Mailing Address: <br /> Phone Number: Gl y� `?6'�16 Phone Number: <br /> Description of Work: �j>l� G�lA2I{ (i�/� o n/ �V��Y_r Az-- <br /> (A <br /> z(A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: ?So -2- iV e-_' Y 4VE <br /> Comments from Inspector during initial inspection: <br /> FD- fF5UV7L <br /> -ji <br /> 66 <br /> CITY Qf E_"v'Ir:PE <br /> PErrr'st ; ��1r;{;- <br /> Approved for issuance by: Date: <br />