Meadowview Application.pdf- - ----------- . . . ......... . ............
MAY 2 3 2014
Land Use Application
DEVELOPMENT SERVICES
1.1 ARCHYFECTURAL DESIGN REVIEW
H COMPREHENSIVE PLAN AMENDMENT
I] CONDITIONAL USE PERMIT
11 HOME OCCUPATION
fJ FORMAL SUBDIVISION
H SHORT SUBDIVISION
FEE RECEIPT #
11 LOT LINE, ADAJSTMENT
14EMZING EkKa..
1-1 PLANNED RESII)ENTIAL DEVELOPKMJ-f
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F) OFFICIAL STREET MAP AMENDMENT
A HE, 171 PB It ADB I I CC
1"7 STREET VACATION
E.] REZONE
Cl SHORELINE PERMIT
L1 VARIANCE / REASONABLE USE EXCEPTION
0 OTIMR:
0 PlEASE NOTE THATALL 1NF0RA1A?Y01VC0NIA1JVED WITHIN THE'APHICATIONISA PUH1JC1?,VC0" 0
PROPERTY ADDRESS OR LOCATION 1.5620 72nd Ave. ,,±
PROJFc-r NAME (it,
PROPERTY OWNFR Meadowview Estates LLC
PHONE # 0 . . . . . .... . . . ...........
ADDRESS 66[5,?tj!k&yeN mid—WA WV ERefjjk o
.. .. ...... .
E-MAIL_X0 lQ0 jp&QVIn
FAX #
TAX ACCOUNT #
SE -C, :fWP.. 27 IZNG..-.. A-1—
DESCRIPTION OF PROJECF OR PROPOSED USE (ATTACH COVER LETITR AS Nr,,CUSSARY)....-----..
4 lot short plat.
DESCRIBE [IOW 'EHE IIROJFCTMEETS APPLICAIII,FCODES (ATTACH COVER LF,'I'Tr�RASNL,'Cl-.SSAItY)-.....--,,.,,,.
.QQnforn) s -w JJ tusel hao le�k,61 nrtaj hAe'r- b "I K.n
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APPLICANT-. d at�QS,L1-.P # -6000
(425)221,
ADDRESS 12516 Willows Road NE Sulto 220 Kirkland, WA ..... . . . . . .... ... . ..... .. .
F. -MAIL FAX
COPfTAC'r PERSONIAGEN'r John Mirant e / I -DG, Inc. pUONr
,# (426)606-1869
ADDRESS 14201 NE 200th St. Ste. #100 Woodinville, WA 98072
r-MAIL.Joliql FAX# (426) 482-2893
. .... ... ....
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 Edmond% 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 wxhl as Ike %vi It ted are true and correct to the best of my knowledge
and that I am authorized to file this applicall kron Ile, 0111111,01ti�eoWl listed below.
0,00
Z
SIGNATURE OF ApPLICANT/Amm, DATE
....... . . .
Property Owner's Authorization
certity 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 fbr the
subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the
sui�jcct property for the purposes of aqwc6onland posting, attendant to this application,
14/.ryDATE
SIGNATUREOF OWN14t
Questions? Call (425) 771-0220.
Revised on 8122112 B ..1 and Use Application Page I oj'l