Applicant Owner Liablity StatementAPPLICANT/OWNER LIABILITY & LANDSLIDE ACKNOWLEDGEMENT
Subject: Larsen Residence, 7329 158"h St SW, Edmonds, WA 98026
This statement confirms that the accuracy of all permit submittal information is warranted by the
applicant/owner (Sharon Larsen) in a form which relieves the City and its staff from any liability
associated with reliance on such permit application submittals.
My application may reference the reports of prior public consultants to the City; however all
conclusions shall be those of me (Sharon Larsen) and my design professionals.
Further, I, Sharon Larsen, understand and accept the risk of developing in an area with potential
unstable soils and understand the required temporary and permanent erosion control and site
maintenance issues associated with specific geological hazards or conditions of the site that may affect
slope stability over time.
I will advise, in writing, any prospective purchasers of the site, or any prospective lessees of structures
on the site, of the slide potential and on -going maintenance issues of the area and on the property.
J
STATE OF WASHINGTON COUNTY OF
hi4 �_ctY Being first duly sworn, says: I am the owner/applicant or the representative
for the above named; I have read the foregoing statement, know the contents thereof, and believe the
same to be true.
Signature of owner/applicant or representative
SUBSCRIBED AND SWORN TO before me this � day of ti� , 20U .
N7STAFFORD
LJENNIFER
taten
RDSignature — NOTARY PUBLIC in and for the State of Washington CORES
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Print Name: � .�,Vj� J
Residingine,JO A -
My commission expires: �_it.�_ L"