21520 89TH AVE W.pdfCITY OF EDMONDS
APPLICATION FOR CONDITIONAL USE
HOME OCCUPATION PERMIT
DATE: ,-,)1,F--7
FEE: 1f,--17V1 -/Y
RECT #:
APO'S:--
FILE #:
HEARING DATE(IF REQUIRED):
.7;k DAYTIME
2 9,,-v
APPLICANT: Z -z ADDRESS: 2-1,52,6 2 AJ fHONE
Indi ate type or degree of interest in the property; All-
, rN661
ADDRESS: — PHONE: T? S 3cl
OWNE�-
Use � one__Z� C)41 —�..(To be completed by Planning Department)
VICI NITY SKETCH: PLEASE SHOW BEL014 A VICINITY SKETCH AS PER EXA-111PLE, INDICATING NORTH.
ST
Exa ple:
W
LocAX�OM o1F i460E)E. USAGE:
INDICATE TYPE OF BUSINESS AND DETAILS OF PROPOSED
REL EASE/HOLD HAR14LESS AGREE%MENT
The undersigned applicant, his heirs and assigns, in consideration for the City
pro I cessing 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'
fee I s, arising from any action or inaction of the City whenever such action or inaction is
basi ed in whole or in part upon false, misleading or incomplete information furnished by
the applicant, his agents or employees.
PER1'41SSION TO ENTER SUBJECT PROPERTY
The undersigned applicant grants his, her or its permission for public officials and the
I for the purpose of inspection
staff of the City of Edmonds to enter the subject property
ancl posting attendant to this application.
ignature of Appl 6ant, Owner
,/or Representative
APPLICATION FOR HOME OCCUPATION QUESTIONNAIRE
Please anwer all questions.
1. Explain the type work that will be conducted at the home.
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?
6. Will you be selling or renting any goods on the premises? If so, what
sort of goods?
7. Do you understand the conditions which must be met in order to obtain
and continue to use a home occupation permit?
8. Can you identify any adverse impacts on your neighborhood which may
result from your operating the home occupation you propose? Please
explain.
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ADJACENT PROPERTY OWNERS LIST
7 t 5-6) -'-,
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De-IL'zV P/1 1'jW,'t'e -2, ! S—z
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On my oath, I certify that the names and addresses provided represent
all properties located within 80 feet of the subject property.
nature of Applicant or App icant's Representative
subscribed and sworn to before me thistliu-,�day of
q ary �Public an�d�for the 3LdLe of ington
Residing at
MY COMMISSION EXPIRES 6-1649.