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APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTh1EtVT <br />3200 Cedar Street <br />�verett, WA 98201 425•'S7-8810 <br />/ <br />�� ��9 �-S <br />Date �j - 1� - <br />Owner Name� � G+� ��1 1`� `1 � h'1 Applicant Name: SG � G� l�1 \��, I G� vin <br />n,a�����„�da�,.�s: �(o�Z� �({1�`^��c�lU..t� �.no�r�a,�da�ess �]�J,.c�e;�� V��,�7 <br />51-c� �,.. �ucr�! � �.. J I� -i% 1..� �- �l �Zl� j <br />�v�re � <br />p G�uZ <br />fnpreF:u�rScr �(nCJ'���• dK�i� Fhoncr.:i_�mLer. <br />Description ol Work: <br />"��_ C'c.s�- G� S�iC,,rnn �'�lrG<<n �i- Cc1C�,-i^ilScoP� <br /><= X 1 � 1'\ v� C� l0 G✓1 I L ��� �GJ C �� CP ' c -} (�\ in 1.1G <br />(r', drawing or pl� �1i�y b-r� need d to illustrcte work �o e dore� I <br />�l' � S� V1Cit i7�U �C''i <br />Site Address� �� � 7 ` J�_ )C-' �� V l C-VJ 1J,/� � J c'.� <br />Comments Irom Inspedor during initial inspection: J�/' �- z Z- O� <br />.�� <br />�E�2 <br />�r��-�PI��J� <br />� .��—_-�..�.��. <br />Approved tor issuance by� Date: <br />