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APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUSUC I.VORKS DEPART%MEN` <br />3200 Cedar Street <br />Everett, WA 98201 425 - 257-8810 <br />Date <br />cc t+L?:rr, C v (a,k,L} : <br />Owner Name:_ err L a- Applicant Name: tl <br />Ma.angAddre«: t'v3)1 -77 ,ti..ai':ingAddress: `LV�� <br />14a5 .�` <br />Phone Numoer: �61J 23�66 / —735D Phone Number. LZ2�� G 1 7� 3 r <br />Description of Work: <br />Site Address: <br />5383oJ�l+�y L7!IsxIST�lfy �i hllllr'1 �lh� �tnr7�C �f4L�,.4.1 <br />iizr; fli its net&O Flil 6j *5 J)ttJYA- - �C6 51#t� Az' Piero" - <br />UJMI. S,S3l e I`/z-�' n D(?� tjj % MOD 1 A w-_ej(wl 4D Ec's�tn� <br />A drawing or plans may be needed to illustrate work to be done) / it T <br />Comments from Inspector during initial inspection: <br />rj,, d -+= t �>C QJ6 C �t `�� d <br />317 /- l-A I �\ R.tia d"-",w j <br />Cr c S i S OV— <br />`� <br />Approved for issuance by: <br />z.s-1-!E(8s3 <br />Date: <br />