01997Mil
CITY_ OF EDMONDS FILE #
BOARD OF ADJUSTMENT -DATE_
APPLICATION FOR VARIANCE FEE $25.00
REC'T #
HEARING DATE:
APPLICAiIT: ADDRESS_ �. PHONE:
Indicate type or degree of interest in the property:,Azej a
OtJiIER:ADDRESS: PHONE:
LOCATION OF PROPERTY (ADDRESS)
LEGAL DESCRIPTION OF PROPERTY:
LEGAL DESCRIPTION! CIiEC,:ED.& ",PPROVED I'
USE ZONE: By Planning Department
f� ZONING ORDINANCE REQUIREMENT:
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7
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VARIANCE RE ESTED:C7
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•% f7 / i i �.r // IC. 1 /1 1 • .�� I
STATEMENT OF CONDITIONS AND REASONS FOR REQUEST, IN ACCORDANCE WITH STANDARDS AND CRITERI�A,�
ATTACHED:
r.
STATE OF WA NINGTON)ss.
COUNTY OF SNlOHOitISH) S gnature of App icant, Owner r Reprentative
i
On this date, before me, the undersigned, a Notary Pub ' i and for t, of
Washington, duly commissioned and sworn, personally appear ,who,
being duly sworn, on his/her oath deposes and says that (s)he as prepared a,.d read tl7 fore- a F
going statements and has acknowledged to me that the recitations contair—ad therein are true,
and has signed this instrument as his/her free and voluntary act and deed for the purposes i
therein mentioned.
Subscribed and sworn to before me this / — day of 19��
residing at
R� otary ub c in and for tine State of ;Jashi ngton.