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� r • <br /> APPLICATION for <br /> PUBLIC WORKS PERMIT �l'V I O(IH-p�y <br /> PUBLIC WORKS DEPARTMENT <br /> � 3200 Cedar Street <br /> E:erett, WA 98201 425- 257-8810 <br /> Date �- � � " �� <br /> �. . i �� <br /> I'"1��n� � Applicant Name: � ��' <br /> Owner Name: � �"��5 <br /> Mai�ing Address: ����� L�✓C� ;'il Mailing Address: �� - � }��' " <br /> 1-. ;�v�, lit.'a. �1��(o <br /> Phone Number Phone Number. N „ �'7`TQ/'c�-�`j�i / <br /> t- <br /> Descriptlon of Work: ��v�v�FC� �� I\ yQ� 3 -� S�,.S�CC ��1 Y`MC �Q L"�'� <br /> `��L,�-evt� �-o e�c���-ti�� C P ,-ri `�i�'v✓ <br /> �� drawing or plans may be needed to illustrate work to be done) <br /> Site Address: � L IO g �/VO��/e ,�/'`, <br /> Comments from Inspector during Initial inspection: �� ��i'L /�T�`�C'��� �D7�S �D <br /> 6-22 -ffl !� <br /> ��S%�'Z t�lZ e�rf �e� /1`e L yv�� � TL' �,r2 �E lTf.2 �.I�1-N �X�57��/4 <br /> C-'L-rV D�Th"r/s, <br /> �- ^ <br /> /k't��=ie LL�m�:t ;o�=-�-z �u ,��E�� y17�(Tc.D sir�-,��a.�_ <br /> � <br /> l�'�� <br /> Approved For Issuance by: Date: _ <br />