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APPLICATION for <br /> PUBL{C WORKS PERMIT � � � o� <br /> l� ETT PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 (425) 257-8810 <br /> Date /2 - 2Z-OU <br /> � � � �/�� <br /> Owner Name: ��i�/�%�����/r'��of1�� C�����'/� Applicants Name: ��/��.�ri�lr, a;�,/ i ,�<<• _ <br /> / , �„� � /�/ <br /> Mailing address: //O �S�v���./ ��i�r� J�C� � Mailing addr.^.�,s: /v��5 /S��i,�� ��/ /�!T <br /> ��:'�: �C�'�l' ( �, ��� �� 2 Ch�> <br /> ���-i 28�/— /2�/� ��o��/i„����'���l/ r'f� 7� <br /> Phone number: P one num ' <br /> c�l Lo�-�a�-9yrs <br /> <1�5��/�5 -�J91� <br /> ���Livas / //''� 9-zS - $83 - CcOS�- <br /> DescriptionofWork: t S�f� G��ii/� 5�� � ����- C�`��� �t%Gl/ 1"S /""c� �r���� <br /> / � / � <br /> ` ( / _S !� �' /�/ -7� ' � v, 4 �- - ' <br /> -��6z-� v i 5- i.-- � !�/(% U � ' �tJ y <br /> > � <br /> L// " i i<i 1 � ( //ii /� <br /> v <br /> 7 C� -- <br /> Site Address: ���I ��t� �L: ��� ��%5 /�� �� <br /> /�_��� � ;��f� G��<< <br /> Comments from Inspector during initial inspection: <br /> � . _ <br /> �.�Ni7EHL �NSpEC"�iGi: /. � <br /> l2c^�,��f��� � �1,� u r= .,; , <br /> KIRK BROQK�C <br /> E <br /> itf';; r �.. ., ...___G_4'__._�— <br /> Approved ior Issuance hy:_ Date <br />