01772EXHIBIT 2
To be filled in
CITY OF EDMONDS
by P1 n ng Div pion:
DATE ('%j'FILE#
SUBDIVISION APPLICATION
FEE RECTI! L `
APO'S v� TITLE RPT
/
LEGALS
Existing Proposed
MAP ,.� GRADING PLAN
EA' EhN.CKLST `
ENV.CKLST FEE
G
/
HEARING DATE:
RECT 11_ \�
r
FEE: I)Preliminary: $110 + $20 per lot
2)Final Plat Check: Same amount as
IN -LIEU PARK FEE
preliminary
ENVIRONMENTAL CHECKLIST FEE: $40.00
1�
RECT p540
Edmonds
Way
i
APPLICANT: Richard J. Blandau ADDRESS: Edmonds.
Wa. PHONE: 778-0306
to
Indicate type or degree of interest in the property:
Owner
�.
OWNER: ADDRESS:
PHONE:
s
(if other than applicant)
1. REQUEST THAT THE -FOLLOWING DESCRIBED PROPERTY BE
DIVIDED INTO 6 LOTS.
LOCATION OF PROPERTY: 540 Edmonds Way
}
r;
LEGAL DESCRIPTION OF ENTIRE PROPERTY: See attached'
legal description.*}•
.
r
I
! S
To be completed by Planning Division:
2; MODIFICATION TO REQUIREMENTS OF DEVELOPMENT CODE.
AP21icant requests that the Hearing Examiner consider the following
mo i icat ons to the requirements of the Development Code.
j
None requested.
RELEASE/HOLD HARMLESS AGREE4ENT
I
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 agent or employees..
PERMISSION TO ENTER SUBJECT PROPERTY
The undersigned applicant grants his, her or its permission for public officials apd
the staff of the City of Edmonds to enter the subject poiperty for the p tpos of
inspection and posting attendant to this application. l) �� �
P*Ownitted
er's authorization, by notarizedature, is required for any application inature of Pr erty Owner or Agent
by an agent.