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� <br /> APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> PUBIIC UJORY,S DEPARTMENT <br /> � � ��;?�� � 3200 Cedar Street <br /> '�"' , Everetl; WA 9H701 425- 257-8810 nl� ���/ �`��1, <br /> Y <br /> Dafe y I 2SI mf3 _ <br /> �pA�+o O. p.uws� <br /> OwnetName: g�`�NE(�- ;�As�K ppplicanf Nome: GA�-2G-TT T w+���.E�-�t,uc7 <br /> Mai�in��nddn.•.;� M�,:Llir�i�Acfdiu;;: P.U, C3U7�C 3�\3-L <br /> _ S6,ATT1�E , WA �9'a�Q'3-1\32 <br /> I'IiOi1�tJi�t;Jir���. Phbni� 1JU�'il7p�: Z�`b' (�32- -1`j`1 \ <br /> DcscriptionofWork: S�-i'w•' T�ctiP�2l�*/ s .'r�c co�c .-2�..c�T«rv �-�u�c,ti <br /> TH(� 1S (�� TPrI-1, w�T� Y��t�.Fc.cv P�7c� ZNl-� <br /> Tr1f� S�Y\S-1N�a PfS'?�H'Y+i-LT S�KLi-f�iC.''h.. <br /> (A �Jrc�winc� or�Inns mny he n'r.FrlrCl 1n iIlU.lrplr wntY, Ip tie d��ne) <br /> Sife Address: �G-i`� C.o�.6S`i ��J�NN{� EV`['�ET � W q , cj caZ,p1 <br /> Commenh Gom Inspeefor d�ring inifial mspecllon: � <br /> I/ ` / �� - <br /> ._.il'_.., �J �,_Y. 1— -�-, ��'�,:J,<,L;' �/'s� �.�r' ��--�,. .� ti— .- �;�G:J�t <br /> 1 <br /> i <br /> Approved lor iss�ante by: Date: <br /> � <br /> / �,. <br />