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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 />owner Namee <br />Mailing address: <br />Y �f •21r� Gtl Q �y�--D n� <br />Phone number: <br />Description of Woricj <br />sins 4 4-C,e s -PQA,, I <br />Date <br />Applicants Name: CWG- <br />Mailing address: <br />Phone number:_ ': � t — <br />Site Address: 869 (`r P��Y'�' G(4' i' <br />Comments from Inspector during initial Inspection: <br />Approved for Issuance by: Date <br />