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\ 1 <br /> /1spyil s , 01/4. <br /> APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> 'y PUBLIC WORKS DEPARTMENT <br /> <e" 'FIT 3200 Cedar Street <br /> Everett, WA 98201 425 257-8810 <br /> Date ZZ,//' <br /> Owner Name: icy/l < .5 /1K;/46.1fS Applicant Name: -_( � �f r <br /> Mailing Address: I CD 23 C 77 Mailing Address: <br /> 6PhonL.) , • "1"., 46- <br /> Phone <br /> e Number: `l L r L/Z2 ._/Cf Phone Number: <br /> Description of Work: ( (S n Lo (9 <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: � /6 3 —C? -5 <br /> Comments from Inspector during initial inspection: <br /> Approved for issuance by: Date: <br />