DNS-Doc #3 - TO BE DONE BY CITY - ESLHA Affidavit of PostingOf EDAf File No:
A
Cttv of ebmollb!5 Applicant:__
Affidavit of Earth Subsidence Landslide Hazard Area
Pennit
tate of Vazbington
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Countp of bnobomiob
being first duty sworn, on oath,
deposes and says:
That on the day of 320_, the site located at
was posted as
prescribed by Ordinance No. 3632 on the subject property. This posting begins on
on the day the City accepts the Permit Application for review and shall remain until
building occupancy is granted.
Signed:
Signed:
Subscribed and sworn to before me this ___4ay of 1 20_.
Printed Name:
Notary Public in and for the State of Washington, residing at
My commission expires:
Packet Itern # 16