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� <br /> Application for <br /> Public Works Permit <br /> Public Works Department <br /> 200 Cedar Street <br /> Everett, WA 98201 425-257-8810 <br /> Date: <br /> Owner Name: AppUcant0anne: 6 0 <br /> MaiUn8Address: Mailing Address: S. \ <br /> Email Address: Email Address: <br /> Phone Nunnber: VD ^fPhone Number: � <br /> . ` <br /> Contact for Permit (Narne/Phone/ErnaiU <br /> Description ofWork: <br /> AMI <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: <br /> Comments from Inspector during initial inspection: <br /> Approved for issuance by: Date: <br />