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�°��� <br /> � � �� � <br /> A�PLICATION for <br /> �` PUBLIC WORKS PERMIT � '� <br /> PUBLIC WORKS DEPARTMENT r,,9' <br /> Everett WA 9 201 r 425eY257-8810 � �C" � k D� <br /> , c a �r�4� <br /> Date O �nL,Pc 21�00� <br /> Owner Name: ���a�++�sG. �'o. I�UD � f Applicant Name: �7e,����eec'S, ��. <br /> Mailinq Address: � O• C�orc 1107 Mailing Address: 2424 c� .��.a <br /> C�m�r �.E WA 9EZQ6 F�Qre�L, vv,4 9B2o 1 <br /> � <br /> PhoneNumber: �[��783-/pOo PhoneNumber: (y2$'� 2$Z'YSGS <br /> GET� o48Z-oZ�-oo <br /> Descr(ption of Work: T�vu So' ( 6ec• 1 3S� �een . J1�o -�ra��; � • C Ic.y c..i� <br /> �•/ , i� c%4oU� (3•Z)�e� wSDOT Y�'iUtC.DZoo3. lA{Ear,l,�t� <br /> � � .'�-ole-Fe�( Nn�w��C � ZDU�e (1g:f.�aM • �:�r) <br /> (A drawing or pla s may be needed to illustra e work 10 be done) <br /> See a1Ea�.�1 v;c�r�4y t-+�ap l <br /> SlteAddress: B•l� f�Ssoc;a{e�( gh,,,1,_itl. d� I=Jue�vSf. I�2: I�at*aeson 4 Sdwkba.n <br /> Comments hom Inspector during InHial inspectton: <br /> '_ .�1���/ CY4' atit �-C. -�o T�if .�/��.w���C GvivSf 6� {"'r�� (c< (iCf <br /> �r -��� Ol.tJI�L✓'/��P�;�F� <br /> �� ., it � , <br /> — �c���✓a� �Lo��� � rl�sC✓ -S�,S�-S' ��.v�-� .�� /��$�al(�C� <br /> as Sloc�ti oh -f� ��{ eC ��c� �Y'oLJ/n� ar �� n.cc���ec� <br /> C�s �hs-{��c��� /��f�ic P�,/Ci� c�or,(s Ti,spe ��e �^. <br /> Approved tor issuance by: Date: <br />