Jodar Land Use Application - signed and dated.pdfCity of Edmonds
Land Use Application
❑ ARCHITECTURAL DESIGN REVIEW 1--'OR OFFICIAL USE ONLY
❑ COMPREHENSIVE PLAN AMENDMENT
❑ CONDITIONAL USE PERMIT FILE # ZONE
❑ HOME OCCUPATION DATE REC'D BY
❑ FORMAL SUBDIVISION
SHORT SUBDIVISION FEE RECEIPT #
❑ LOT LINE ADJUSTMENT HEARING DATE
❑ PLANNED RESIDENTIAL DEVELOPMENT
❑ OFFICIAL STREET MAP AMENDMENT HE STAFF I PB ADB CC
❑ STREET VACATION
❑ REZONE
❑ SHORELINE PERMIT
❑ VARIANCE / REASONABLE USE EXCEPTION
rl OTHER:
• PLEASE NOTE THAT ALL INFORMATION CONTAINED WITHIN THE APPLICATION IS A PUBLIC RECORD •
PROPERTY ADDRESS OR LOCATION 8717 240th St. S.W.
PROJECT NAME (IF APPLICABLE) 240th St. S.W. Short Plat
PROPERTY OWNER David V. Jodar, et al PHONE # 425-776-1677
ADDRESS 8717 240th St. S.W., Edmonds, WA 98026
E-MAIL FAX #
TAX ACCOUNT # 00463301500400 SEC. SW31 TwP. 27N RNG. 4EWM
DESCRIPTION OF PROJECT OR PROPOSED USE (ATTACH COVER LETTER AS NECESSARY)
The proposal is for all approvals related to a 4 lot short subdivision on a 1.0 acre, RS-8 zoned site which
ron s the north margin o ne existing singe tamily dwelling will be removed. Access to
Into in the site well hp pmvidPrl by pdyntP arr.Pss PasPmPnt ThP site will hp sPrvPd by sanitary sPwPr and public water.
DESCRIBE HOW THE PROJECT MEETS APPLICABLE CODES (ATTACH COVER LETTER AS NECESSARY)
(See attached Statement of Code Compliance)
APPLICANT Adamant Homes, LLC PHONE # 425-318-7687
ADDRESS P.O. Box 14790 Mill Creek WA 98082
E-MAIL larry@adamanthomes.com FAX #
CONTACT PERSON/AGENT Jim Egge / James Egge & Associates PHONE # 425-388-1698
ADDRESS 10807 25th St SE, Lake Stevens, WA 98258
E-MAIL jamese-a@msn.com FAX #
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 Edmonds harmless from any and all damages, including reasonable attorney's
fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information
furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge
and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATUI'H:` OF APPLICANT/AGENT DATE
Larry J. Sundquist, partner, Adamant Homes, LLC
Property Owner's*thorization
(�1O �� , 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 permission fort ublic officials and the staff of the City of Edmonds to enter the
subject property for the purposes of inspec4io and osting a ant to this application.
SIGNATURE OF OWNER a,_Jn d DATE C
s ' s? Call (425) 771-0220.
Revised on 8122112 B - Land Use Application Page I of I