3a - Subdivision_Application_SIGNED BILL.pdfCity of Edmonds
Land Use Application
ARCHITECTURAL DESIGN REVIEW
❑ COMPREHENSIVE PLAN AMENDMENT
❑ CONDITIONAL USE PERMIT
❑ HOME OCCUPATION
❑ FORMAL SUBDIVISION
SHORT SUBDIVISION
❑ LOT LINE ADJUSTMENT
❑ PLANNED RESIDENTIAL DEVELOPMENT
❑ OFFICIAL STREET MAP AMENDMENT
❑ STREET VACATION
❑ REZONE
❑ SHORELINE PERMIT
❑ VARIANCE / REASONABLE USE EXCEPTION
❑ OTHER:
PROPERTY ADDRESS OR LOCATION 9801 Edmonds Way (NE comer of 100th Ave West & Edmonds Way)
PROJECT NAME (IF APPLICABLE), SH 09020 Wal reens Edmonds WA
PROPERTY OWNER Tom Rocca -Seven Hills Properties PHONE # 415.247.7377
ADDRESS 88 Perry Street, San Francisco, CA 94107
E-MAIL trocca@sevenhillsprop.com FAX#
TAX ACCOUNT # 27033600113200 SEC. 36 TWP. 27 RNG. 03
DESCRIPTION OF PROJECT OR PROPOSED USE (ATTACH COVER LETTER AS NECESSARY)
See attached cover letter
DESCRIBE HOW THE PROJECT MEETS APPLICABLE CODES (ATTACH COVER LETTER AS NECESSARY)
See included narrative
APPLICANT Tom Rocca - Seven Hills frqpqrtiqs _ _ PHONE # 415.247.7377
ADDRESS 88 Perry Street, San Francisco, CA 94107
E-MAIL toc.c.seven w s op�cm_,. .......... ....— FAX #
William M. Ruecker
CONTACT PERSON/AGENT Baysinger Partners Architecture PC PHONE # 503.546.1600
ADDRESS 1006 SE Grand Ave #300, Portland, OR 97214
E-MAIL billr@baysingerpartners.com FAX # 503.546.1601
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to
release, indemnify, defend and hold the City of E 10 s harmless from any and all damages, including reasonable attorney's
fees, arising from any action or infraction based " w to or part upon i islea 'rig„ inaccurate or incomplete information
furnished by the applicant, his/her/its agents or e1 pl ees.
By my signature, I certify that the hifiorm w n hibits s0t1a cd a true and correct to the best, C my nowtcdge
and that I am authorized to file this apph w o r cha o I as list below.
SIGNATURE OFAPPLcmrr/AGEtdI .,. L.,P_. _ _....... _... DATE..,. L
Property Owner's Authorization
I, ________ , certify under the penalty of perjury under the laws of the State of
Washington that the following is a true and correct statement: I have authorized the above Applicant/Agent to apply for the
subject land use application, and grant my percussion for the public officials and the staff of the City of Edmonds to enter the
subject property for the purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER DATE
Questions? Call (425) 771-0220.
Revised on 9114110 B -Land Use Application Page 1 of]