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Land Use Application_20181127_Resub.pdf
City of Edmonds RECEIVED 2018 ti r Land Use Application NOVf. _, ��SEVE. -�.ES ❑ ARCHITECTURAL DESIGN REVIEW I I COMPREHENSIVE PLAN AMENDMENT ❑ CONDITIONAL USE PERMIT ❑ HOME OCCUPATION ❑ FORMAL SUBDIVISION ❑ SHORT SUBDIVISION CI LOT LINE ADJUSTMENT IJ PLANNED RESIDENTIAL DEVELOPMENT ❑ OFFICIAL STREET MAP AMENDMENT J STREET VACATION El REZONE Ll SHORELINE PERMIT ❑ VARIANCE / REASONABLE USE EXCEPTION ❑ OTHER: *PLEASE NOTE THATALL INFORMATION �CONTAINED WITHIN THEAPPLTIONISAPUBLIC RECORD • PROPERTY ADDRESS OR LOCATION Z 20 2? 6 tIC:ti �o�G L'� PROJECT NAME (IF APPLICABLE) G✓a5t (� '�o�✓�' /,- Q PROPERTY OWNER �yLc—ts �CL,S� ' / PHONE # ADDRESS 2,07, _ 114 fk l�i� (/�' E-MAIL FAX # TAX ACCOUNT # 005�y�2-00/ O ZAW SEC. TWP. RNG. DESCRIPTION OF PROJECT OR PROPOSED USF (ATTACI I COVER LETTER AS NECESSAR ) 6116 lee 61P, efz,i en 2L✓ 1.4k DESCRIBE HOW TI II_. PROJI:C-f %41-1=.1'S APPLICABLE CODES (A t I ACH COVER LET —TER? ,S NEC ISSARY) APPLICANT 0/01 , / I ' ADDRESS Ss� .,�ds��l V 17ds U, E-MAIL / a' j- � a cc CONTACT PERSON/AGENT r"g.4 ZGt. ✓C�/(.r ADDRESS 2-1 ) y�✓f E-MAIL kdn4 b /V44 �b/�ct, 1�jyh FAX # PIIDNf# �6©-fq�`r��/ 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. SIGNATURE OF APPLICANT/AGENT DATE Property Owner's Authorization $.certify under the penalty of perjury under the laws of the State of Washington that the following is a true and correct sta ment: 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 attendant to this application. ��11 SIGNATURE OF OWNER /� ./�� t?Ln.:'k0kN DATE I v I Questions? Call (425) 771-0220. Revised on 8122112 B - Land Use Application Pa.gc I of 1 City of Edmonds --.._=- r Land Use Application ❑ ARCHITECTURAL DESIGN REVIEW ❑ COMPREHENSIVE PLAN AMENDMENT ❑ CONDITIONAL USE PERMIT FILE # ZONE ❑ HOME OCCUPATION DATE REC'D BY ❑ FORMAL SUBDIVISION F SHORT SUBDIVISION FEE RECEIPT # ❑ LOT LINE ADJUSTMENT HEARING DATE ❑ PLANNED RESIDENTIAL DEVELOPMENT ❑ OFFICIAL STREET MAP AMENDMENT ❑ HE ❑ STAFF ❑ PB ❑ ADB ❑ CC ❑ STREET VACATION ❑ REZONE ❑ SHORELINE PERMIT ® VARIANCE / REASONABLE USE EXCEPTION ❑ OTHER: Modification Request for side setbacks* • PLEASE NOTE THAT ALL INFORMATION CONTAINED WITHIN THE APPLICATION IS A PUBLIC RECORD • PROPERTY ADDRESS OR LOCATION 22027 96th Ave W Edmonds, WA 98020 PROJECT NAME (IF APPLICABLE) Groset 2-Lot Short Plat PROPERTY OWNER Marcus Strash & Courtney Fagen PHONE # ADDRESS 22027 96th Ave W Edmonds, WA 98020 TAX ACCOUNT #—00544200102800 SEC. 27NO3E25-S DESCRIPTION OF PROJECT OR PROPOSED USE (ATTACH COVER LETTER AS NECESSARY)_ Two lot short plat, house t stay on existing lot. New single family home proposed for new lot. A Modification Request is neccesary to reduce the side setback from 7.5' to 5'. D erT&( 20 85 O10 project meets allCtin�mg�necessaryCYor a general requirementsvaiiance. S eattachedco letter. APPLICANT Ola Groset PHONE # 425-422-5464 ADDRESS 8506 Bowdoin Way Edmonds, WA 98026 E-MAIL— ir)agroset@yahoo.com FAx # CONTACT PERSON/AGENT Donna Breske & Associates,LLC PHONE # 360-294-8941 ADDRESS 21 Ave A, Suite 4 Snohomish, WA 98290 E-MAIL donnab@donnabreske.com F YE 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. SIGNATURE OF APPLICANT/AGENT �tn/11� DATE 11-20-18 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 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 attendant to this application. SIGNATURE OF OWNER DATE Questions? Call (425) 771-0220. er Revised on 8122112 B - Land Use Application Page 1 of 1