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CHIP <br />�� �� <br />To: <br />From: <br />Date: <br />� <br />C►TY OF EVERETT <br />CONQv1UNITY HOUSWG [MPROVE NT PROGRA:bi <br />� ����v�� � D <br />Plans Examiner, Building Department J <br />MAR 15 2004 <br />! , CHIP Staff � '_r.'j'�y ��}•�'�yERETT���� <br />Enginp.arinq!NeAua pa,,,,k,s <br />3-i2-o� -- <br />�aY <br />I <br />� <br />. , t,. :.. ► � <br />Owner's Name <br />Project Address <br />Attached are the Repair Specifications for the above mentioned project. Please provide <br />CHIP the following information by initialing the proper box. <br />Yes <br />Plan check required: � � <br />3�I8�� <br />Please retum this form o IP as soon as possible. <br />� <br />Thank you. �_ <br />No <br />� <br />CITI� OF E�'ERETT <br />'��;n 11'�unurr A�cnue. Suiic ti00 • E�ercu. �L'A 9R'_01-J0�1 <br />��l'_�� _'i7-S7;i . F:t.� ��l?91 _'$7-86'_R <br />