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7W I t3e-7-V'�'j <br /> APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> y, PUBLIC WORKS DEPARTMENT <br /> zfi EY ETT 3200 Cedar Street <br /> Everett, WA 98201 425 - 257-8810 <br /> Date —71 <br /> 7 2 � S <br /> Owner Name: kQL Applicant Name: <br /> Mailing Address: \205C�✓c. c,y,l��L�,Mailing Address: \2c5 Q=,�S c�-, \ lck� <br /> Ye <br /> Phone Number: (1 ' S� 25�( - 3�C�Lk Phone Number: �y�) �� , _ 0-7 03 <br /> Description of Work: <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: 2,l C-,2 � , mak, l ( of 9-,2G� <br /> Comments from Inspector during initial inspection: <br /> Approved for issuance by: pate: <br />