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Application for <br />Public Works Permit <br />Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 425-257-8810 <br />Date: � �.�>` - � `C <br />Owner Name: ���� �U�� Applicant Name: {�� l�-�C-�- t- � � <br />Mailing Address: v�J [ 3 l_-�=�►-�b�- S) Mailing Address: 2� � y- —����. S`! - <br />�L���— �- � � �� ( <br />Email Address: <br />Phone Number: <br />Contact for Permit (Name/Phone/Email): <br />�` �.�� �[' � ^�, � � <br />Email Address G��✓1�1-�1���v1�� �( `�C�►M�S�; ►� <br />Phone Number.�T`fi-2�� 2J� �G��,� j <br />Description of Work: G�='��vE ��'� �� �'�`��S ��t-' l��tZ=� 2�l-� l�� �i�'�7�"�'� <br />�-ti� '�t�� � ���� �� � ��-��=w�rC.(�- �� �=��� <br />� � X �� � � � � �� ��� 5� � i U1�lc f'v(� ��-NZ-i� �,�t1 ;' <br />�� <br />(A drawing or plans may be needed to illustrate work to be done) <br />2� ��-- � c��� �� ��� <<�� � <br />Site Address: � <br />Comments from Inspector during initial inspection: <br />� ._ j y=-� � , , � � ; __� �� ; <br />. . � � i � � iC� 1`'�` y�a 1 <br />��L-n f�1 i�" I� � I� 7 <br />`��`� � <br />Approved for issuance by: Date: <br />