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�;�,� i � c��- - �� i <br /> APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> PUBLIC WORKS DEPARTMENT <br /> � 32U0 Cedar Street <br /> Everett, WN 98201 �125- 257-8810 <br /> Date , �� � <br /> I-��� � �« A Iicont Name: L , l"�rEr' ���t 5^�� <br /> Owner Nnme: pp <br /> fvlailing Address: Mailing Address: <br /> Phone Wumber. Fhone Number. l�'Z,�^_ �7� ' 2 j j� <br /> Descriptlon ol Work: �E" �LN�� �5���''� T P/fiV' �(� W,% /1 CoN�rt L�/ cs <br /> 1=��% S��'rljC:rc�J r/155�'4'G� wry ro�c. '��' � <br /> (A drawing or plans may be needed to illusira?e work to be done� <br /> Site Address: ��� ��'• C�:S �,�c /L� <br /> Comments from Inspector durl�g initial Inspection: <br /> Approved tor Issuance by: Date: <br />