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<br /> � APPLICATION for
<br /> PUBLIC WORKS PERMIT � �'J
<br /> ETT PUBLIC WORKS DEPARTMENT
<br /> 3200 Cedar Street ��
<br /> Everett, WA 9P?01 (425) 257-BB 10 L;�.�;
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<br /> Date _U � 1 1 � o i
<br /> Owner Name: ' , . `,;� , ., c ApPlicants Name:_��� , . .� \� \Z�c_�:� �
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<br /> Mailing address �� �' • �I l t� �� ` •, i Mailing address: ��-�3��� I lt 1�. '�� '�L.
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<br /> Phone number� � � � `1��• i. Phone number.. (�t: 5 � �S"; � � `��� (•i, �
<br /> Description of Work: �=• .A�� :�e .�c c . � � .��\ �� � ��� ,. ��,c-
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<br /> Site Address: �' � ' �• �1 ,' � ��� ' � � , '• �`�
<br /> Comments from Inspoctor durtn� Initlal inspectlon:
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<br /> Approved (or Issuance by: Date ,
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