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�.��uc�o�-��� <br /> s , ��:��� Application for <br /> a� .: ���� <br /> �` Public Works Permit <br /> �: <br /> � - ��� Public Works Department <br /> a•.;: <br /> ,;�;,: <br /> _ '�� 3200 Cedar Street <br /> Everett, WA 98201 425-257-8810 <br /> Date: � 2 ZU� � <br /> . (� ,, . l� � �1. <br /> Owner Name: r��p�J I:���V� Applicant Name: ��'� � `-l�'�'��'� <br /> Mailing Address: ��� G�'..�v��. �1�2. Mailing Address: -�,P.��l`�� ���tL,ti� ��'�'� <br /> �'� 1�1�i�.,��_��2��i �7l� '1,����� �.��v�,� <br /> 4�� � . [��: n <br /> Email Address: ��-�vt�4�L���-��:"��Email Address: ���(:yi,"�'� , ��� I° <br /> Phone Number: Phone Number:���� ^ 2� '— ���� <br /> Contact for Permit (Name/Phone/Email): �C',�b l �)L'Vt-1'�t'�,, <br /> �lS ��,,,�1�:�,i,t,c�� ���- ,h'�' 4ZS -��•-`�l�: I <br /> T-- <br /> Description of Work: l"7 IT�- � �1�(�,�j`f-��'���� � �-f��6�LC1'�i:�— � <br /> V �-Y�-lv���i_�'�� <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: �'��� ��j � lV�:�"t�TC . �/U�_ t �,L-� <br /> Comments from Inspector during initial i pection: <br /> _ <br /> ;_ , s , ,. <br /> ++ f � i� . I �.., ���� ," �.� � � w �� <br /> A( _ �_• I.._ a _i �._� i � � i , j . <br /> 8S j'�'a•'t',7 � �i � .'1 <br /> 91 � � <br /> � <br /> '��' 4 'I i':�`,��' [J f i /_l;i� i �-.r`f 1 <br /> Approved for iss�a'nc�^by: ..��* r Date: <br /> ° �_ ` '� , << � ,�,w..y..� 9 <br /> - Y,�.�.....x.� <br /> 2....,-,.-.--., ��w, � �t� ���� r� <br />