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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 <br />Owner Name: A-/J <br />Mailing address: 9°/QCC''�`5t •5. <br />"5nl014CH16I4, luA 98•-9& <br />Phone number. I <br />Description of Work: <br />Site Address: <br />Cve✓eyl 11,)A l8 ad8 <br />Comments from Inspector during initial Inspection: <br />Date 07 ,,78 -00 <br />Applicants Name: &&0( c. G MLrK t,0 <br />Mailing address: <br />Phone number. <br />Approved for Issuance by: Date <br />