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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 I /,) 2 2, <br />Owner Name:', •71 <� <br />Mailing address:.2737 tuCsi" `mwm ,- ye 41 <br />Phone number: <br />Description of Work: �ns aff .7 <br />HA2//U�// <br />Date �? A ✓ <br />i <br />Applicants Name: �cc•�e��iare rn�,i�F( 5/%. t; Pi <br />Mailing address:.�yGt2/�:r�, G,i �a•y'. Sit ?W <br />_!5�, ffe t�14 P6/311 <br />Phone number: Z616) 30&-1g0 <br />,•,% 0;(I, cxc .r- <br />.:If oAy p e shpAs I've"s e c��� k� >t Ab xlws&ti) el <br />Site Address: '71-131 Rucker 6i,&4 <br />Comments from Inspector during initial inspection: <br />S(,nShC�0 6P <br />�u&&,,w�L <br />Tpi yecao�S d,� ,e„S <br />l <br />kc< fF <br />cc)t +r0l <br />I � -t� c ILl <br />[I TC D. <br />Approved for Issuance by: Date <br />