land use application.pdfCity of Edmonds
Land Use Application
ARC=CT�,7Ft-kL DESIGN PLE'%IEW
COMPREHEN0,7E PL_ -1L Mmnnzzi���
\,7A,MENDMEN`T
CONDITIONAL T TSE PEKT FILE' Z01
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HOME OCCT�'PATION DATE REC D BY C
FORNLkL SUBDn7SION
SHORT KTDr%,1SI01a'1 FEE RE=4
LOT LINE ADJUST.WIENT PIEARrG DATE
PLA2SL;ED RESIDENITL-%L DZ,T-Lop,,EN-T
OFFIC1,41 STREET NLkP AMENDMENT HE I CSTAFF PB AD13 Cc"
STREET
REZONE
SHORELINE PEF1n11T
7,7ARI.-,NCF REASONABLE USE EXCEPTION
OTHER:
a PL.E.4.5.ENPTE TH-4 I -4LL DTORIL4 T10.N'CO3VT-9XED Tr YTHLV THE APPLIC 4 TIONIS.4 PI-BLIC AECORD
PROPERTY ADDRESS OR LOCATION SR104 at or near MP25.03
PROJECT N-.k%IE (IFAPPLICABLE) SR 104, Safety Grant Wil Mock Pedestrian Crossing- PedestiJan Bievele Program
PROPERTY OWNT.R— WaOinglan Staic, Dept. of Trans (WSDOT) PHONE 44 l206) 440 4643 ngr fi206l 440-4547
ALDDRESS t,570(11 Damin,'Avenm K, NB82-138, PO Box 330310, Seaffle, WA 98133-9710
F.kX i (206) 440 4805
TAX AC C'0 7\7'1` SEC. Drp � PNG.
DESCRIP,710\'OFPRO.7F-CT¢DRPP,OPOSEDT-TSE(ATT.A,CHCO%*ERLETTFRAS�N7ECFS'S-,kRY)_-rl,,,cur D,),,/s-,o",..'a'ri+,
Cr n4 "'M conor-t.mid-block pedestrian crossing on SR 104 in the vicinity ofEdmonds City Park, between
fhe nm,—di he mid-biock crossing wfli provide connection from the sajewaUt on Me west
A., of SR p04 pay . pde, ol an r rad that pead, to Edioon ds Ci&y Park on the cast side of S1tU14, at approximateiy SR t04 MP 25.03. A Me h-biterBity
WW"U.'d (rW;M mk (jPk%% K) si,,,na.N1Wn1,,fl h,; in,mfled m the crossing torenhanced pedesttian smiety. (See ktter attached.)
L)ESCFdBE HOWTHE PROJECT 1,1EETS APPLICABLE CODES (ATTACH COVER LETTER ASNECESSARY)_
N/A
-4,PPLIC.LNT Mm LaughHn, or,kkberet (Aebroghzabiller PHON 6) 440-4547
. E 1 (206) 440 4643 o� (20
ADDRESS 1"7010 DaYtOVIA-,naie.NN13,82-138, P0 Bcn� 330310, Seattle, WA98133-9710
or FAX 1 (206) 440 4805
C ON TACT PFRSO'.VAC;F NT Saineasappiumt PHONE
ADDRESS
E-.\IAJL FAX #
TLe irtidersigrred applicant. and hisherl'it; heim and assigns, in consideration on the processing of the application agrees to
release. indensitiB% defend and hold the City of Edicionds, harmless from any and all damages. 111cluding reasonable Ittornev's
fees. ansing (roan any, action or infraction based in whole or part upon false. raisleading, inaccurate or mcomplete infonnatioll
famished by the applicant. pais Iver agents, or ernplovees-
By My slgnaftlre. I certifw that the infornsation and exhibits herewith submitted are true and correct to the best of ray Intowledge
mid that I am atallonzed to file this application on the behalf ow
the oivneT as listed belo
z
OF APPLICkN'T.rAGE\T DATE
Properti- Owner's Authorization
certify tinder the penalty of perjury under the laws of the State of
'Nash in 2 toil that the fbllmvn g, is I truce and correct Statement: I hive authorl7ed the above Apphca:IVAgent to apply for the
subject Lind use applicationand sirmat any permission for the public officials and the staff of the Ciry of Editionds to enter the
subject property for the purposes of inspection and postrag attendant to this application.
SI&NATI:RE OF OV-,lER TATE
Questions" Call (425) 771-0220,
?njs",J On S — 2 -, E - Lana' De Applacoiion Page 1 aft