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$' APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> 'ET7 PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 (425) 257-8810 <br /> Date 7/24/2015 <br /> PW Permit No. PW1507-048 <br /> Bldg Permit No. 101 / <br /> Owner: Mailing Address: Phone: <br /> MUSTACHE LAND DEVELOPMENT PO BOX 12176, <br /> BOTHELL, WA, 98082 4252440549 <br /> Applicant: Mailing Address: 1 n O kt' Phone: <br /> MUSTACHE LAND DEVELOPMENT PO BOX 12176, <br /> BOTHELL, WA, 98082 4252440549 ��,�� R` ���5 Co LL�cu 4 <br /> u � <br /> Description of Work: NEW DUPLEX c�/ <br /> I t{) /e.r - e Qc h .S/c% a-( <br /> ,de p is x (A)fa Aave °- <br /> Site Address: 5209 GLENWOOD AVE � l,�� ��' SQA ce, -''`it <br /> / PeX- heed to be zs/„-,4//c✓ �Y <br /> Legal Description: _ Sys. c/Cv 4e - cru C !e wa7'(er de721: C.s/;.0,2 <br /> g-a 4 has 41ce kielo d, to,LC <br /> Comments from Reviewer: <br /> ` SeLve� - one 70 — <br /> 7—i'74,1-6-c; / it p!a/ &/ o1/, at Seider, riprhi <br /> UTILITY INFORMATION <br /> Meter Only 0 Complete Service 0 Install per building or per unit? (circle one) <br /> Size of water meter <br /> City of Everett Sewer: yes or no (circle one) <br /> Approved for Issuance by: Date: <br /> Pb) P � so JI ,P V/—et-J 12c / <br /> @/'jvr/ '� �t'c�Sfl1 h CE7i7 rtJ� 16 1a1(, 15 <br /> r -r).SPQ-cfie h Yl 21) Di--v t✓eit.y 2c <br />