19305 89TH PL W.pdfCITY OF EDMONDS FEE:
APPI.TrATION FOR CONDITIONAL USE
RECT #:
HOME OCCUPATION PERMIT APOIS:
FILE #:
HEARING DATE(IF REQUIRED):
APPLICANT:
-30Y U)PHONE:
____ADDRESS:
Indicate type or degree of interest in the property;
OWNER: ADDRESS: PHONE:
(To be completed by Planning Department)
Use Zone
VICINITY SKETCH: PLEASE SHOW BELOW A VICINITY SKETCH AS PER EXAMPLE, INDICATING NORTH.
/V P/-: bi)
Example:
ST
14 C
VO
LOCA'TtOM oF 1460e)F—
INDICATE TYPE OF BUSINESS AND DETAILS OF PROPOSED USAGE:1--"':-
RELEASE/HOLD HARMLESS AGREEMENT
The undersigned applicant, his heirs and assigns, in consideration for the City
processing the application agrees to release, indemnify, defend and hold the City of Edmonds
harmless from any and all damages and/or claims for damages, including reasonable attorneys'
fees, arising from any action or inaction of the City whenever such action or inaction is
based in whole or in part upon false, misleading or incomplete information furnished by
the applicant, his agents or employees.
PERMISSION TO ENTER SUBJECT PROPERTY
The undersigned applicant grants his, her or its permission for public officials and the
staff of the City of Edmonds to enter the subject property for the purpose of inspection.
and posting attendant to this application.
�f Applic*t, owner
gnature o� lic1J
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............
APPLICATION FOR HOME OCCUPATION QUESTIONNAIRE
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Please anwer all questions.
1. Explain the type work that will be conducted at the home.
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2. What area of the home will be used?
3. Will anyone be employed at the home besides yourself? If yes,..
'please.
explain who and when employed?
.4. What type of equipment will be used in conjunction with the
home.
occupation?
5. Will there be any visits to the home by clients, employees,
delivery,,
service, etc? If so, how many, when, etc?
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6. Will you be selling or renting any goods on the premises? If so, whit,
sort of goods?
7. Do you un derstand the conditions which must be met in order
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to obtai'
and continue to use a home occu ation permit?
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8. Can you identify any adverse impacts on your nei ghborhood which may
result from your operating the home occupati on you propose?
Please
explain.
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