Land Use Application.pdfCity of Edmonds
Land Use Application
❑ ARCHITECTURAL DESIGN REVIEW
❑ COMPREHENSIVE PLAN AMENDMENT
CONDITIONAL USE PERMIT
HOME OCCUPATION
❑ FORMAL SUBDIVISION
X SHORT SUBDIVISION
❑ LOT LINE ADJUSTMENT
D PLANNED RESIDENTIAL DEVELOPMENT
❑ OFFICIAL STREET MAP AMENDMENT
❑ STREET VACATION
REZONE
❑ SHORELINE PERMIT
❑ VARIANCE / REASONABLE USE EXCEPTION
❑ OTHER:
• PLEASE NOTE THATALL INFORMATION CONTAINED WITHIN THE APPLICATION IS A PUBLIC RECORD •
PROPERTY ADDRESS OR LOCATION 921 Pine Street
PROJECT NAME (IF APPLICABLE) Fairwinds Development Short Plat
PROPERTY OWNER Estate of L. Joan Demeroutis
PHONE # 206-999-5599
ADDRESS 921 Pine Street, Edmonds, Washington 98020
E-MAIL dustinremington@gmail.com FAX # N/A
TAX ACCOUNT # 27032500105500 and SEC. 25 TWP. 27 RNG. 3
DESCRIPTION OF PROJECT OR PROPOSED USE (ATTACH COVER LETTER AS NECESSARY) The instant proposal is
for the subdivision of a parcel containing_�nro�mately26,170 square feet into three lots for the
construction of three new homes. The exiting home will be demolished.
DESCRIBE HOW THE PROJECT MEETS APPLICABLE CODES (ATTACH COVER LETTER AS NECESSARY) The new lots
conform with the buk regulations of the RS-8 zone in which the property is located All development will
be completed in accordance with City reQuirements
Steve Neilson
APPLICANT Fairwinds Development PHONE #
ADDRESS
206-949-2223
E-MAIL Steve@FairwindsDevelopment.com FAX # N/A
Jeffrey Treiber
CONTACT PERSON/AGENT Lovell -Sauerl and& Assoc., Inc. PHONE # 425-775-1591
ADDRESS 19217 36th Avenue W Suite 106 Lynnwood Washington 980
E-MAIL Jeff olsaen ing eering com FAX # N/A
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 o% ier as listed below. /r7
SIGNATURE OF APPLICANT/AGENT - i �G �Ci`�— DATE Z
Property Owner's Authorization
1, Angel Demeroutis , 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 for the public officials and the staff of the City of Edmonds to enter the
subject property for the purposes of inspection and posting a nt to this plication. p
SIGNATURE OF OWNER DATE r l
Questions? Call (425) 771-0220.
Revised on 8122112 B - Land Use Application Page 1 of I