02215CITY OF EDMONDS
BOARD OF ADJUSTMENT
APPLICATION FOR VARIANCE
F I #
DATE 3- 7
FEE
RECT
APO'S
HEARING DATE :3- ( 7 � -
APPLICANT IV( �. ! ���. ADDRESS
CITY & ZIP &J 1 I r Q Q 1 PHONE { a'
INDICATE TYPE ' OR DEGREE OF INTEREST IN PROPERTY
LOCATION OR.ADDRESS. OF PROPERTY w
LEGAL -DESCRIPTION OF PROPERTY
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VARIANCE REQUESTED:
FOR OFFICE USE ONLY
STATE OF WASHINGTON) ss.
COUNTY OF SNOHOMISH) n�
Signature of Applicant,Owner, or
Representative
Public inYf&r th_gOn this date, before me, the undersigned, a Notaryy appeared}
of Washington, duly commissioned and sworn, p s that (s)he has prep d
who, being duly sworn, on his/her oath deposes and say
and read the attached statements and has acknowledged to me that the recititations
contained therein are true, and has signed this i trument as his/her free and
voluntary act and deed for the purposes ther, i tdiaynedf• 19
Subscribed and sworn to before me t
Notary Public in and for the State f Washington