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Document Title(s)
Reference Numbers) of Related Document(s)
y � - Additional Reference Ps. on Page
Grantors
Additional Grantors on Pag' e
Grantee(s)
Additional Grantees on Page
Legal Description (abbreviated form: ie Lott8lock/Plat or SectionlTownshipfRange)
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Complete Legal on Page
Assessor's Property Tax Paraef/Account Number
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Additional Parcel irs ,on Page
The Auditor/Recorder will rely on the -information provided on this form_ The responsibility for the
accuracy of the indexing information is that of the document preparer.
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Legal Description: CA0A 5AW- OOY As
Assessor's Parcel Number: 31 Ac)(0-70C)i0 0
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory
Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County regarding the regulations im aged on Accessory Dwelling�JUf its.ia A
Property Owner Signal
Property Owner Name
Date: (n - t L _ � - l
STATE OF WASHINGTON)
COUNTY OF SNOHOMISH )
I certify that I know or have satisfactory evidence that a t �'Ci_ AS 14 t -iC A ( I
signed this instrument and acknowledge it to be his/her free and volumtary act for a uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated: `5,,,
Signature of
Notary Public: —&- LA -- r -(�� , —, -
Residing at: ft
My Appointment
Expires: 3 "_e— --
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR
NokRy Public.
StWie o1wasltift9to"
ROUMIANA SAEINAS,
MV Appointment Expires Jul 25., 2011
A.DUstatement.doc