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�L�Z.ClSe �idC+ <br />� i`G� (.LV`Y1 TO <br />APPUCATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425 • 257-8810 <br />Owner Name: �` ��y � �V�il4'f� AppNcanf Name: <br />Mailing Address: ,j�� �e..du � 5� Mailing Address: <br />�v�2e�'! I,�Q sJ� <br />Phone Number, y�S�a S 7- fJ,�O d �'��one Number. <br />-�� co��d�� <br />F ! I'� �� <br />����? <br />�� �� <br />Date �J' ' r - � o <br />Desctiption of Work: (T�JS-�� Se �%�5 c�c.u.:'�-cr; .+y P a� , c R�,.,,,,cJ [�� (, <br />�.�.�. <br />aJ� nra-f�c;� l �sfo�a�Q �„ 2d <br />�� drawing or plans may be needed lo illuslra�e work lo be done� <br />u ��5 <br />Site Address: � C��� <br />Comments from Inspector d�ring initial inspeclton: <br />U <br />� �!%C//�� 7 'p � c�one �- x4h� /'Gvi,l'Cd Oh �-�D-L�;3. <br />El�incc•-cf ��/ %/m h9ar,Fs Q��a� <br />/ <br />� /)QIL� CiT`; �%�L=�I�1� CG.i.4�i Q� Cl C� /-//>!'�S <br />�'i c <br />�. /`l/.f �.ih, i 4�, �avc,s Gh �/ �1�ej('eJ�'4:,� �4r/! c�c,r,E � <br />�.%j� rfn�cl�t� �nCi,. '��.f S/�L khC� /•rC SV.^rAUn�/j��, l/.,et. <br />l� <br />7, �/'°''��/ 4:,y I,��cc11'4�,y e,rcl�cr� �e�,�/huC 4�!' �r-�ac�e�� <br />!/i/ f�)Q O�E�S/4�n �IlCjyp[�. <br />`/ U <br />Approved for issuance by: <br />Date: <br />