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�& APPLICATION for <br /> PUBLIC WORKS PERMIT n <br /> �ETT PUBLIC WORKS DEPARTMENT N� JQ���/l <br /> ; 3200 Cedar Street <br /> � � "�'��`� Everett, WA 98201 425:�z57-8810 <br /> Date `Z—Z ( Q <br /> Owner Name: ��NNO��S� �DS�L�Appiicant Name: ( S�"'��1 � <br /> Mailing Address: Z� l� CL�V�L.,�� �/�vlpiling Address: <br /> Fil/���� �7,�j�T <br /> Phone Number: ��j �q`� �j�� Phone Number: <br /> �(z� 3 a�f �S3( �(� <br /> � � � <br /> Descripfion of Work: <br /> �e�� <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: � �- `� � � �,�����1,� ��_ <br /> Comments from Inspector during initial inspection: <br /> ��j . <br /> .._ /"� �YI y.�vV� musf �lof -�jo 2C� <br /> � � ��ef �h � ��f S-e��� � , <br /> � � <br /> `�""���.. �r`r�s�� l <br /> �i��;�Z�� �►� <br /> Approved for issuance by: Date: <br />