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APPLTCATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425 - 257-8810 <br />Owner Name: L�,�,�� ���'' ` Appllcant Name: <br />h1ailinq Addres;: ��7 �'l J"�'� ��' 1 ��� MailingAddress: <br />��- .a�� � �-� �4;-��_,�, <br />, <br />Phonc Numb�:r. �i") � -`� I ; I., y c(i Phone Number. <br />Description of Work: ! y 1� �' <br />Date ��_ <br />(� drawiny or plans may be needed 10 illustrate work 10 be done) <br />Slte Address: � >> � � �� �. � � �� �� �-% <br />Commenls Irom Inspector during initial inspection: ' / <br />�it.G f�G4�� L�C2t� %✓l � 7�'LOr�tn ci���itG� ���'1e �%W�� �GL <br />c�u�ot .�W��/ �Z" ���+" Trr�B'fdhl j'lq,.�l�+� �� � <br />g2s-Zs� ��S"l <br />��j i/-i7_N O� /Jl7i�c 1d�7 i1/v�s <br />Approved for Issuance by: Date: <br />