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,- r <br />t �`'�� <br />t1, :'`� Ji , - _ <br />�✓ ~�~ <br />Application for <br />Public Works Permit <br />Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 425-257-$810 <br />Date: �'� , %�� � <br />:, ^ <br />, /� <br />Owner Name: ,�,1���� C% Appiicant Name: v��/� /ly��r � <br />� �' <br />Mailing Address: � L� �� {�, � S�j �- f�,,� Mailing Address: S`i� L <br />, <br />/�1�,%,"/ t-�a , �i.�. 9g.� �j' <br />Email Address: <br />Phone Number: ��S - 1�.�5� �,' �� <br />Email Address: <br />Phone Number: �5�; =�l Cs <br />Contact for Permit (Name/Phone/Email): �� ��, %( ����'�����5���� �j�i�'�/ <br /><< '� � �'��,,,�' � �„����/_' '� �� � 75�� -% � 7� <br />Description of Work; <br />� <br />IQ�n-�a v.� 30 � dr -- Tr ��.J ;'N �/�� � <br />A ha� �' �`�/ � h� s f��� ti o/Qs, <br />(A drawing or plans may be needed to illustrate work to be done) <br />p _ � <br />Site Address: � �� � �' dr - D� PAn �v-� Ey�r �fJ �'+�/�. <br />Comments from Inspector during initial inspection <br />Approved for issuance by: <br />pc�rt� i <br />s fu.��o. f <br />z���`i3t-I�O���:�C� <br />�= <br />,�f��: � � . <br />r„ <' `—' ! � o a <br />� �� <br />� �. I�� 0 V € � '� ;�� � ; � !.. <br />Date: �� <br />, . C. .. <br />�I�� ,.: r_`�;�-:��:T; <br />a � .1`) 'h "V ; 1!1 <br />��ciB..�q :e.�t=' ^:� <br />"-r.`�.^.---�-�....._ .'�;�'. �_.�,.�..� <br />