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APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> EY ETT PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WP, 98201 (425) 257-8810 <br /> Date: 1011 0.1201> <br /> Bldg Pert-nit BWO.023 <br /> C)v�a��a►: iuiaiiii�s isics : piwllo: <br /> BURRUSS MICHAEL F 3015 21ST STREET <br /> EVERETT, WA, 9£3201 <br /> Contact: Contact E-Mail Address: Contact Phone: <br /> [ContactName] [ContactEmail] [ContactlPhone] <br /> Description of Work: GARAGE FOUNDATION ONLY & SLAB ON GRADE <br /> Site Address: 3015 21ST ST <br /> Legal Description: READY LAND CO S 1ST ADD BLK 012 D-00 -W 22FT OF LOT 12 & E <br /> 17FT LOT 13 <br /> Comments frorn Reviewer: <br /> N,..�-�� �L g-l-l BE�.>� YoU �l� (ygh►�: t� ad va�l.c.�> <br /> UTILITY INFORMATION <br /> Meter Only ❑ Complete Service ❑ Install per building or per unit? (circle one) <br /> Size of water meter <br /> City of Everett Sewer: yes or no (circle one) <br /> Date: <br /> Approved for Issuance by: lQ � / <br />