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CITY OF EDMONDS
APPLICATION FOR CONDITIONAL USE
HOME OCCUPATION PERvilk
APO'S:
FILE #:
HEARING DATE(IF REQUIRED),�:�
-J -7—
APPLICANT.- ADDRESS: PHONE:
Indicate type or degree of interest in the property;
OWNER: ADDRESS: 'Z/ AS'r—HAI Id PHONE: 77&-610 70
Use Zone (To be completed by Planning Department)
VICINITY SKETCH: PLEASE SHOW BELOW A VICINITY SKETCH AS PER EXAMPLE, INDICATINGiNORTH.
Example: ST
A ve-
41�
t
ST it
14
L 'TIOM oir V46USF—
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INDICATE TYPE OF BUSINESS AND DETAILS OF PROPOSED USAGE: 0 Ph v 1 -5 raze,/
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.
ignature of �Ap llicZant, Owner
or Representative
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APPLICATION FOR H014E OCCUPATION QUESTIONNAIRE,
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Please anwer all questions.
Explain the type work that will be conducted at the home.
2. What area of the home will be used?
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3. Will anyone be employed at the home besides yourself? If yea, please
explain who and when employed?
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4. What type of equipment will b�e used in conjunction with the
home',
occupation?
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5. Will there be any visits to the home by clients, employees,
del3'-very'.,,,:,,
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 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?