|
F
<br /> �. �
<br /> �y{" , ; ..� � n.
<br /> i � i �
<br /> .,��.� Gt�� ...q r __._..
<br /> ��. . xie ��.Py
<br /> D. � +.eNwu�
<br /> �.`tec �I_ �E:n1 ' .:y
<br /> � �
<br /> `�'1P�(,i-i�:� {v
<br />�~1"...'.��t�Y.t M 14`L 1" yy.�
<br /> ,�1 '� .., '�{\% RY
<br /> "" ;:� ��'�� —' AppLICATION for +0 , :;���
<br /> � ,�, ��.
<br /> y a���.��;., ,� PUBLIC WORKS PERMIT ��
<br /> y„�_ E� �� PUEiLIC WORKS DEPARTI�IENT �
<br /> i ,tis . 3Z00 Cedar Street y,,
<br /> �"` -" Everett, \NA 98201 47_5- 257-8810 €;>
<br /> �4, � �� �
<br /> ., „ ,;
<br /> � �
<br /> , .,
<br /> 2 " t�7 �2 b'`�
<br /> Date U (d �''�,�;t�
<br /> � �,�
<br /> .;�
<br /> a' 1
<br /> t��p� �al
<br /> r�N- �II'�l/ ! $ t.
<br /> �jr� Owner Name: (IGCi�1 Applicanf Name:
<br /> ��� � �;
<br /> '�`' 1.4ailing Address: �� � f i t/� f:",oiling Address:
<br /> ;,y
<br /> *, ;
<br /> ri
<br /> �. �( 1 � ' 'A
<br /> ���
<br /> 5{c Phone I�!umber. _���- i1lf 5� ,��,one Number: _
<br /> ',r
<br /> ,.;
<br /> �-'7�;,
<br />�� � I
<br /> Descripiion of Work: ��/�, �� � � �`�
<br /> e�
<br /> �' � , .
<br /> 1��
<br /> t` ` � —
<br /> \x� _
<br /> i
<br /> �t t:�`- '.4� .
<br /> ��� `5` 1
<br /> ,��`� �^ �A drowing or plans may be needed fo iliuslrafe work to bc donel i ��
<br /> � '�. �' ,
<br /> i ji� T2y
<br /> � k
<br /> �,�7 G2� 1r�,, �I �
<br />� �'� Site Address: �23Z� 93�f � I �V 1'fU�� iV�i i
<br /> $��, ���.
<br /> ` ' 'Y , Commenh from Inspeclor during initial inspection:
<br /> � ��
<br /> �� � � �iI`/�lT —. � �jO���r�i� �b '^Z % f�' � ' �G w �i�d�!
<br /> „_2. tia,..�� I A� J^'G'Y� �! '1 S � t_ �
<br /> �� ` � i '/7 /��i_ i/ �J ` �
<br /> J .� /��R.
<br /> �� ��o T���� �,�o�i�v� is ;s�ri.�ir�c�� ii�� r�-�c ��c
<br /> G oc'l,�T/o�./ /�iZ G�E,-r='` 77zG/c'.c< _ ��'F'-iGr;�:?�'c
<br /> 77z�/L'/c T�'��,�-✓C /�//<L f�1�v'G %O T�/��,/ �y.�y�,�
<br /> ��� 4 '� �9� . �/J i.���� /�/ 7�� �i�� Sir�
<br /> C'c�i�/S�4G/�'�/'TG y T��"��L' C'O��rl2L�G !��/GG /,�C
<br /> �/���-�� -f`�-�T T/�`/S /'�:>/i?r�/G/1��G'�
<br /> Approved for issuance by: Date:
<br /> � �¢P Ci� -�t�e�`�' CL¢.r.h a¢ a lC fi:J,c�s
<br /> C ��r vid� 4n�/ G�✓^o.S��� Co�� ��oL cLS CY/rC�C`�`U t �Ix -
<br /> �� / ( 4
<br /> iN
<br /> ._._„.�..�
<br />
|