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: <br />��:�, <br />t'�•; � %�•% <br />�GC.)13C�'> QC'w' <br />Application for <br />Public Works Permit <br />Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 h25-257-fi810 <br />Date: � � Zr � Z - <br />�� <br />Tn < . <br />OwnerName: � � '�'�� � �� �--' �"; �}��APp�icantName: �� � <br />MailingAddress:7sn u.� �1 <br />il✓�1�' �'�, �1y2�� <br />EmailAddress: �w�ka`�'��t'"�`,��$ �"" <br />PhoneNumber. �`1Zs�'Z3`i `1�i�'I <br />Mailing Address: 5`��"'�-- <br />Email Address• S � <br />Phone Number: � •��` <br />Contact for Permit (Name/Phone/Email): ���� ���' <br />Description of Work: <br />(A drawin� or plans may be needed to illustrate work to be done) <br />\ i_.,. .Jl �. CI j� � 1 — <br />Sitc Address: "1`'l �'\ � �U `�' ' � �— <br />Comments from Inspector durin� initial inspection: <br />�pproved for issuancc hy: <br />Date: <br />