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S6� <br />F <br />, EY EIT <br />w. <br />Owner Name: <br />APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />EvPrett, WA 9it201 (4250 257-8810 <br />Date <br />,���� <br />���OZ � � <br />, �s¢ � J(�aV- <br />� ��� pti""� <br />�n L <br />���.�/n �,;rlo..,cso�� ApplicantName: r-.��Kt�.z�'��,f��'-�c�.�-•� <br />Moiling Address: [.c i4 L-=if`' ti'i �(� nr�ailing Addre;s: ?�'��� a=_ <br />�iiuorv�: y�. 1,., f��' ^ Ir <br />{i'Qt+S�P� <br />Phcne Ncmber. Phone Number. y �/� S—�O/ — yf�� <br />Description of Work: <br />�.�.�•,�C� �n 'kan�f �Mc�.1�lc' [� �it t-ro�'Y� ���:��' •FC <br />(�drawing or plans y be ne ed to illustrate work to be done) <br />�e�.�iy SA�oc. W�.tb� :3 .Sti!'.tv�g 6� �owci- %�bD(�a <br />Site Addresr. 5 2t�( . '�}�" Se•-ncj `,<-��i- � I' ve.�tF- <br />Comments trom Inspector during initfal inspection: <br />� <br />�J--'�'�^�+o CJ� �(i�'lC_ ��-r fi��lh C�4'�i.� <br />rGe� C��Y 51w:.ds CC�.���, n-I- a(C -Fiv,��Ei . <br />Approved for iasuance by: _ Date: <br />