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� <br />.�� <br />,,� �.4..� <br />r� <br />t� <br />�° ,� <br />�z`"`Y�` ,.� � - - <br />��µ:,::;; - <br />L� <br />Application for <br />Public Works Permit <br />Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 425-257-8810 <br />S����i <_ c.� W �,S �� ,� <br />�-_---- \\ Date: � � ( r <br />a <br />��l <br />�'// �F �/ <br />Owner Name: , ���l� �r� — Applicant Name: �Y j'''�Q--� � � J�� "� ( <br />MailingAddress: �(� ,l���'' .33� MailingAddress: <br />� �� �ti� ���� <br />/��� �, , <br />�, � ,�-;�. ��,��. <br />Email Address: ����s���i!�G?(l�►'�'�S�`�k3�`Email Address: _ <br />Phone Number�� �Ji ��^�' S�� Phone Number:_ <br />�� �� � <br />Contact for Permit (Name/Phone/Email): <br />Description of Work: <br />,�? <br />�> <br />��;���.% <br />"' , ) r I <br />����� � Y <br />(A drawing or plans may be needed to illustrate work to be done <br />��� ✓� �,v� � <br />Site Address: � ��2��¢l� �',�^, �/' <br />Comments from Inspector during initial inspectiorL <br />Approved for issuance by: <br />Date: <br />» / Q <br />C�1G� S Jj <br />���--�; �16 <br />1����� <br />