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APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> PUBLIC WORKS DEPARTMENT AYE ETP 3200 Cedar Street <br /> ' Everett,-WA 98201 425•- 2.57-8810 <br /> Date <br /> Owner Name: t Applicant Dame: �,:!a <br /> �l n',. <br /> Mailing Address: ' Meiling Address: q7 p /V/ <br /> ✓fly <br /> 11066:t <br /> Phone Number: o1L�l�• �(� Phone Number: �� ��-�`���9 �� <br /> _ ,SGa'7T <br /> Description of Work: ^A rb&q� 4Ed-d AJJi, exLc:,Lk: Q 7"YCriii�d�AB,[�f GHQ,/ j <br /> (A drawing or plans may be needed to illus ra .e work to be done) <br /> esu e r . <br /> 4 <br /> Site Address: ��1� <br /> i <br /> Comments from Inspector during initial inspection: <br /> i <br /> I <br /> t <br /> I <br /> I <br /> Approved for issuance by: Date: <br /> i <br /> i <br /> ! <br />