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APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425 - 257-8810 <br />Date <br />�r <br />�� ����v'.� l <br />(a—%%—v% <br />Owner Name: <br />�,��2y P�o��x ApPllcantName: C�AIZ2Y �dv�x <br />I�hailing Address: l 93 Z V�2 C_ —����C-�Mailing Address: <br />C: �t�`�Z C•'T% `"�A . <br />Phone Number: � jZS � 17" O S I% Phone Number: <br />Description of Work: <br />Site Address: <br />�o�c-�z7Y F�u c c-- <br />1 q3 v�2 c i,v�� A��; <br />jA drawing or plans moy be needed to illustrale work to be done) <br />/ �13 Z V � �� /Ni/a � v� <br />Comments from Inspector during initial inspeclion: �/ 1� <br />(� Z�' 0 � - P �.�er� i � 'D�u�i �-2 /�. `fiG1� f Y7L� in -�izG -F <br />se�l�ac�'� �ti��di ir� -/lw �iJr�t O�- GU� i5 lim�'it�/ � <br />�Z�� �l7 h-G9 Jlif Gil')!� i��LiSf" l�G �[� u`(S� J?U� �{h�lli''Gr� <br />�1� �vi7f s��lG�a�� iy ��aSar��1 -harr� �t�w -hv��f ,��v�xr� <br />„ --�iar�� -/�rua.�L� n� � l2vu� �lv � i�r�'�� <br />Ui � � � <br />111�r�'7,�Y1n�� b4ll� �c���r�s -�2� �'utr ���Yu �iopirl�-� �e��c� <br />Grtrz /x Q�'%.i�j'^- �;s lo; `�zcsN ��izN57�l�z- x32�1 <br />r,/1y O �C S�OFwnLks oi?�/ 7a �6-��s�miarJs• ��o �t,(.6J <br />/ g �i��efc��la ��F /y/N ' oTJ Sio6-wA�ks y <br />qpFroved for issuance by: Date: <br />