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. - �,' '.*+ <br /> - APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> , PUBLIC WORKS DEPARTMENT <br /> � 3200 Cedar(Street �nr � O�(,��p –(JC <br /> � Everett, WA 98201 4250 257-8810 r� �� <br /> c' �— <br /> �ate G'��J 7�� <br /> Owner Name: �y� �•��f`� Appiicant Name: ��^"!` �'I� ��o` <br /> hta;ling Address: �• � ��K ZI `"1 _ Moiling Address: �I�''� �C�-/�'���lue <br /> �GC���w�- /c.G.� �UC�� w� �7ri2D I <br /> Phone Number: 3�U " )LI — 53� Phone Number: '�f2 S—ZS�' Gs'Z a' <br /> Description of Work: �-�N�� �r�., � ��+f� a� C �rn-� �: �� <br /> � �1 �D � V <br /> �A drawing or plans may be neec ed to illustrate work to be done) <br /> SHe Addresr. �5U � �. l�4��nc (/,�rJ p�•�C <br /> � � <br /> Comments hom Insp_ ec�duiing-initial inspection: �d--� <br /> �� � S .n,, 1 <br /> �_��' f? � <br /> / ���.� , �„j,= <br /> V"" <br /> ��r� �� <br /> Approved for issuance by: Date: <br />