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APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> PUBLIC WORKS DEPARTMENT <br /> `� 3200 Cedar Street W��OS�LZ <br /> Everett, WA 98201 (4250 257-8810 P <br /> Date `,� A `I G� �,..��� i, <br /> Owner Name: 1 C NI PL L U L�11 I (' (�- Applicant Name: ''� �CN A LL C 1'L DS S <br /> Mailing Address: � y' � `-' f_ D NI T3 A1C D Mailing Address: � �U �J I 3 47 H D R - SE <br /> ! VERE71 g �3z01 `,NONCIMISM �� �'�� °D <br /> Phone Number: �I Z �� - � � �- 1 I! S Phone Number: � Z 5 � 3 a�4 ` 1713 <br /> Description of Work: F' �UE' f�A Iti '�rI i�a G �,1, E!\ `i l'Jf�L KVl/l�lY P � R n� nrraF n <br /> 517[ YLAN. TF ALLUWEb� WC WOUL � LIKE TC? <br /> }�A1/C -1 �! F A1� EA SETVI/EEIJ TN E ALL�Y �4- \PlALKWh`(S <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> I ��! I n'IS 4 -� 8 1N AllDITION. <br /> Site Address: �� �'� L [7 �!� IS I�T( n � L \� (_ ?' E l7 <br /> Comments from Inspector during inittal inspection: <br /> Approved for issuance by: Date: <br />