02264CITY OF EDMONDS
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BOARD OF ADJUSTMENT
APPLICATION FOR VARIANCE
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DATE3
FEE
RECT #
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APO'S
HEARING
DATE:
APPLICANT. / 1 _ ' �/✓ova J� ADDRESS
CITY &ZIP �C1 1rYldl? �� PHONE
INDICATE TYPE OR DEGREE OF INTEREST.IN PROPERTY CfLcJyte'y
LOCATION OR ADDRESS OF PROPERTY
LEGAL DESCRIPTION OF PROPERTY ,j��, / 712 1--:;' Z? jc G�" D ?
VARIANCE REQUESTED: ,( % D� A g�t /7
FOR OFFICE USE ONLY
USE ZONE: -�
STATE OF WASHINGTON) ss.
COUNTY OF SNOHOMISH)
Signature of Applicant,Owner, or
Representative
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On this date, before me, the undersigned, a Notary Public inr an
for t LtQ,
of Washington, duly commissioned and sworn, personally appeared.
who, being duly sworn, on his/bar oath deposes and says that 4w)he as prepared
and read the attached statements and has acknowledged to me that the recititations
contained therein are true, and has signed this instrument as his/how free and
voluntary act and deed for the purposes therei mentioned.
Subscribed and sworn to before me this day of 19`y —.
Notary Public in and for the State of Washington
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