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APPLICATION for <br />PUBLIC WORKS PERMIT <br />FUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Evzrett, WA 58201 (�+25) 257-6810 <br />Date <br />Owner Name: Cf a- �� c Applicants Name:_ ,�'�; �, � <br />�Y1ailingaddress: S�'C�'�� �CLri��?e'r �ci <br />�'.� �-.� �-�, �v�. ��a� <br />Phone number ��� � ,_�$�- 3�� {( <br />Description of Work: <br />Site Address: ��pi� <br />tvtailing address: Svn7 F- <br />Phone numbec_ �jl�s� -� ' <br />��-<• ) <br />n. . , . <br />O'C I �Y �jQV�ry LJ/Plfi��hl�`jl <br />/ � O <br />Comments from Inspector during initial inspection: _ <br />, �e� p �, �j� s�,� ,�_w,_ ,� �.P.P �� <br />,�v.os.o�� cm�•�roL a..s c�rEc�zd �� <br />-- f�j�a v��� � <br />f� � G�,l i,�v�cr� GJor�t 1t„s�e���r <br />,� <br />Aporoved !cr Issuance bv Catr <br />