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APPLICATION for <br />PtJBLIC WOP:KS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425 - 257-8810 <br />Date / 3� <br />Owner Name: ��-��Am R�Y/.�„� Applicant Name: <br />� <br />Maiiing Address .3i/ 3� S�7L-_-e7— Mailing P,ddress: <br />C-iJ c=Yzs�T' rti .i- 9 u`� �/ <br />Phonr IJumber. ��Z�� i23. �/z }�o Phone Number. <br />r <br />Description of Work: r�,-.� c` o�c �. �� 2� ��/T n� ti�Y <br />�A drei�ving or plcros may I�e needed fo illustiafe work to be dor�e) <br />Site Address: :3i1 � c�� � ��'-��- % r,=.i�7z:.T �..,s° <br />Commenls trom Inspector during iniiiai inspection: ��" /� ��-�;S) <br />�it�'C'E l L�a(S'� i7�� �t�c r1TL�:i: 2�' /�'u/_ll�) cr= Ex /57�a�G� ;%Di>J-/ �),��0 <br />/ll��J(/�:1�(111 ��EICI�`f C(= i?�ii <br />�� � <br />�� � <br />�. �` ��S <br />f /'� '� <br />Approved tor issuance by: <br />Date: <br />