Tiersma Comment Form.pdfCITY OF EDMONDS — F11 ANNING DIVMION
COMM EN"I'1:0 RM
PW -Engineering Fire 0 PW - Maintenance 11 Parks & Rec. 11 Building
0 Economic Dev. 0 Parks Maintenancd
Project Number: 14 N20140022
Applicant's Name:—PETER-71 E13"S M,A
Property Location: 22318 92111D Ave, W,
Date of Application: 0&'11,'14 Date Form Routed:— .06,17 14
Zoning:_SkIgL�Y
e Egn�i� eskjential (RS -,4))
-R
Project Description:_,TWO L0TSUBDl1dIWQ114 EMSPING liQ� �SE WlLL BE DEMOLMHED
"PER ECDC 20.02.005 ALL Z70MMENTS MUST BE SU1 W!* WITHIN 16 #AYS *F 1HE 70-=
THIS FORM WAS ROUTED: [AJE �BY 07/0'7/2014,
If you have any questions or need clarification on this project, please contact:
Responsible Staff:_.Jen M,achuLq Ext
Name of Individual Submitting Comments:
Title:
El I have reviewed this land use proposal El I have reviewed this /and use proposal
for my department and have for my department and have
concluded that IT WOULD NOT AFFECT concluded that IT WOULD AFFECT MY
MY DEPARTMENT, so I have no DEPARTMENT, so I have provided
comments. My department may also comments or conditions below or
review this project during the building attached.
permit process (if applicable) and
reserves the right to provide additional
comments at that time.
Comments (please attach memo if additional space is needed):
The following conditions should be attached to this permit to ensure compliance with the
requirements of this department (please attach memo if additional space is needed):
0010
Signature:
Phone/E-mail: