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APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425 -j 257-8810 <br />-''-- �-i <br />Owner Name: �.l ��-' , (� i� C�- U�'�" �� Applicant Name: <br />Mailing Address: <br />Phone Number: <br />Description of Work: ( J✓� ; J e� <br />Mailing Address <br />Phone Number: <br />� <br />Date <br />G' % /� � <br />/ / �C"� I C��.(J/J7/i.Y2 CLJ-�.. <br />�� � � <br />/ ���c��� <br />�7 v� `;' �,�,� �' � s G - � <br />L� <br />� z5� �'' 3`� -- ,� %� � <br />(A drawing or plans may be needed to illustrate work to be done) <br />, �, ,� , .�--� <br />Site Address: i'� i ��� ��r� �� � l,l��'^ ���� �-� U-�--- <br />Comments from Inspector during initial inspection: <br />D [�C�[�0�� <br />n SEP 23 zo,o <br />CITY C3F EVER�TT <br />Perm�t Services <br />Approved for issuance by: Date: <br />