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city of ea�m�onds
land use application
ARCHITECTURAL DESIGN BOARD
COMP PLAN AMENDMENT
CONDITIONAL USE PERMIT
Ll HOME OCCUPATION
El FORMAL SUBDIVISION
L3 SHORT SUBDIVISION
L3 LOT LINE ADJUSTMENT
EI PLANNED RESIDENTIAL DEVELOPMENT
Q OFFICIAL STREET MAP AMENDMENT
STREET VACATION
0 REZONE
X SHORELINE PERMIT
E3 VARIANCE / REASONABLE USE
EXCEPTION
0 OTHER
FILE # ZONE
DAT REC'D BY-6
FEE� EYA RECEIPT# 11,1-1 (e_1
HEARING DATE
HE El STAFF El PB E) ADB Q CC
TAKEN:
' APPROVED Q DENIED 0 APPEALED
PEAL#
Applicant -Pcr.�- op ecin'Onds Phone ('Ao .) '7et97i,4.-o5i11
Address - SB(, Adrv,'snal (A Fd—o—ls i-AIA ck'962 en
Property Address or Location __Ad(�,4rtx(
Property Owner 'Por4- o-C &ftroncis --Phone - (,;?0(. e,,,s1jq
Address S S G Arlrv%t r-a I W 244 r=r-(MQnCk WA qsnQ 0
Agent Y6j5ePAgsPhone r7Rq -i(gqg(�
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Address qQq Eqniql, 7j�r_ _,;1rtL4_ c
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Tax Acc # a -2 1 - YA YA Sec. '2'6 Twp. 'P-7 Rng. S
Legal Description -s=
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!Details of Project or Proposed Use,, P_+tAm dP_6,;�eh;:9 Na rpt_nns�=+ qm'69
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The undersigned applicant, and his/ her/ Its heirs, and assigns, In consideration of the processing of the
.application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all
damages, including reasonable attorney's fees, arising from any action or Infraction based in whole or in part upon
false, misleading, Inaccurate or incomplete Information fumished by the applicant, his/ her/ its agents or
employees.
The undersigned applicant grants his/ her/ its permission for public officialsand the staff of the Citv of Edmonds tol
enter the subject property for the purpose of inspection and posting attend -
SIGNATURE OF APPLICANT/ OWNER/ AGENT -Attachment 2
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Vicinity and Zoniong MaD
41
Attachment I
File# SM-96-147
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