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%',JClll-D12 <br />APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257-8810 <br />Owner Name: 0 11 v(J I P U, ; <br />Mailing address: F� IIy I / 7 <br />veq <br />a. <br />01 <br />Phone n:imber: 02—����) 3q <br />Description of Work: <br />Site Address: <br />Comments from Inspector during initial inspection: <br />Approved for Issuance by: <br />Date L P— nt <br />Applicants Name: 1�114 , ,«; _ /1 <br />Mailing address: <br />Phone number: <br />Date <br />