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Owner Name: <br />Mailing Address: <br />�I���� 3�-k <br />a <br />APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBL.IC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425•-257-8810 <br />Date <br />�oP>S9^�l� �f1�C�`� <br />2�c c(- C f a, 4� q J�. <br />s✓ t-f-L 7� a 5 <br />Applfcant Name: <br />Mailing Address: <br />Phone Number. l�-2 S L(-C� Z �f-S C 0 Phone Number: <br />Descriptfon of Work: <br />Site Address: <br />s a� n L-t ��n v e <br />c� <br />�Gv' "j . � ¢G �- <br />z— <br />���:�� - � z o� <br />4s — <br />l,�s -c�f�°'`. <br />�/0 7� <br />P�� a-���. �o� <br />6�1����- <br />(A drawing or pians may be needed to illustrate work to be done) <br />C 4- � f����C /�1t <br />Cornments from Inspector during tnftial inspection: <br />� � / �. ?L•"O% - j4 <br />�J�oTh� „ � <br />-��x o�e.- c ,Cc, <br />�� <br />,-�t <br />� Ci vi�G ConS����'t �io <� L�JOr,� Z�v OC c�oh� Pc�.Y <br />j�Ce•� o�P/�nvCclo�i 7-/d-D7 CC'o�rai�c��e� <br />_ j L l n��S� c�.[,. :/ S�ja /L /fje c����[ P�" {%Lni, a���/rcvc o� <br />lnn/�,Gii,. C' U(/ �JC ��t(i �LG/�i�in� d�.�GI"�o"it�7T, ✓B <br />/ / / /� /) <br />Approved for issuance by: Date: <br />� <br />