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<br />Application for
<br />Public Works Permit
<br />Public Works Department
<br />3200 Cedar Street
<br />Everett, WA 9$201 425-257-8810
<br />Date: ����
<br />Owner Name: - - �`J� Applicant Name: �����
<br />Mailing Address: �C'��/��1���� Mailing Address:
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<br />Email Address:�/� C���'. � /�������Email Address:
<br />Phone Number. G��f L�,� ��v��� Phone Number: �������� ����
<br />Contact for Permit (Name/Phone/Email): L� �c l�� �G �
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<br />Description of Work:
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<br />(A drawing or plans may be needed to illustrate work to be done)
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<br />SiteAddress: ��G � /Ll/��C�i�`` ,�.o,�� �`�l��/����Cit
<br />Comments from Inspector during initial inspection:
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