LandUseApplication.pdfcity of edmonds
land use application
ARCHITECTURAL DESIGN REVIEW FOR OFFICIAL USE ONLY
COMPREHENSIVE PLAN AMENDMENT ^ I
CONDITIONAL USE PERMIT FILE # if 2�8003s ZONE
HOME OCCUPATION DATE S O REC'D BY vC A
FORMAL SUBDIVISION FEED c D RECEIPT #
�G SHORT SUBDIVISION
LOT LINE ADJUSTMENT HEARING DATE
PLANNED RESIDENTIAL DEVELOPMENT HE TAF PB ADB CC
OFFICIAL STREET MAP AMENDMENT
STREET VACATION
REZONE
SHORELINE PERMIT
VARIANCE / REASONABLE USE EXCEPTION
OTHER:
PROPERTY ADDRESS OR LOCATION 10727 226th St. S.W., Edmonds, WA 98020
PROJECT NAME (IF APPLICABLE) Kari Johannessen Short Plat
PROPERTYOWNER Kari Johannessen PHONE#
ADDRESS 10727 26 h St. S.W., Edmonds WA 98020
E-MAIL ADDRESS FAX #
TAX AccouNT # 27032500310300 SEc, 2 5 TwP. 2 7 RNG. 3
DESCRIPTION OF PROJECTOR PROPOSED USE The proposal is for the Submission of
the subject property into 3 lots for the construction of 2 new
_ences. The existina residence will remain.
res'
APPLICANT Leif Helleren PHONE# 425-770-1970
ADDRESS P.O. Box 1764, Edmonds, WA 98020
E-MAILADDRESS Stevens1043@comcast.net FAx# 2.06-533-8200
CONTACT PERSON/AGENT Lovetl–Sauerland & Assoc. PHONE# 425-775-1591
ADDRESS 19400 33rd Avenue West, Suite200. T,ynnwnnrl,_ WA 98036
E-MAILADDRESS—mikem@lsaenciineerinci.com FAx# 425-672-7998
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 arc 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/T/ A1`r�f �` DATE
Property Owner's Authorization
By my signature, I certify that 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
This application form was revised on 1/27/00. To verify whether it is still current, call (425) 771-0220.
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