Restlawn Application.pdfCity of Edmonds
Land Use Application
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Tim tandarsiped appliefilit, and IlMer/its ljoirs, said awips, in cOnsidw4tion on, the ptoceastlIg of thef4)j)jie4tio4 1t 0
[*[baso, indvoroN. (1011CO) M14 hold the City of FArnonds banWess fnnn apw,
any =4 all dallwgcs, including muortable anamay's
rem adsing ftni (VIN, aclion, or hirknetion based fin Wtole or part upoll false, rnisleadki& inaccurate or jincOnIplele i),fenmtjojj
Ainas1w by the "PlAicant, hiAorfits agalts or employees,
13Y YnY Si$natWo. kortiry that the information and exbbits herewith submitted are true and oonvat to the best of my knowledge
and that I ann tnjtjxxi7,ed to jrllq this application on the behatrofthe owgaas listed below.
SIGNATURE OF
Pr011ert.Y Nwer's AnthorWfloin
DATE i
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71 —dult M"Y W)d*[ the JXOW� Of PedUq under the laws of nx, swo or
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subject IWO Use appIkation, and grant my slatemam' I bAve OUUMIZOd the Above ApplicanMgent to apply ft the
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dW P%)Wo Offici8b and the stflfrofthe City ofFAnoods to elk, the
subject PFOPe4 for ft of insptVA1011 a1*7's t—
F�Ne -1to this al'wplicat'don.
SIGNATURE OF
ReWsedon
DATE
Questions? Call (425) 771-0220.
page I Of f
ECEIVEC!
MAR 2 3 2017
DEVELOPMENT SERVICEt,
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