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;,�,_:y^,,, <br />��`• <br />�=EY ET7 <br />� :.g t. <br />'':• '- ... <br />APPLICATION for <br />PUBLI� WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425- 257-8810 <br />°G� I ol i,oG3 <br />Date ��—� � �� <br />Owner Name: t *�'1 _��5,�(��� Applicant Name: �i ��G i1 L'�.��5 I <br />Mc7iling Fdd'ess: ��� f N �G/-f'l�1 1Y � � Mpiling Address: <br />�v��t� 9��4 <br />Phone Nurber G��-�j �j -�j �-�(�N(� Phone Numbec <br />Description of Work: <br />(A drawing or plans moy be needed to illusfrate work fo be done) <br />Site Address: <br />Comments from Inspector during inifial inspecfion: <br />Approved for issuance by: � ( , Date: f I��� �U <br />� <br />