00003MW
CITY OF EDMONDS
PLANNING COtIMISSION APPLICATION FILE NO.�k�'
EDMONDS, WASHINaTON FOR SHORT SUBDIVISIONS & SUBDIVISIONS FETE
Submit in trip icate REC 0•
SHORT SUBDI
VISION - (4 lots or less; fee is $10.00 per lot). Hearing Date
SUBDIVISION - (5 lots or more; fee is $5.00 per lot, or 1/20
of one cent per square foot of lot area JinUthe plat,
is 0. This fee
whichever is greater. :1inimum fee
'is applicable to both preliminary and final plat sub-
missions)*******************************
22 Main St.
`. .
ADDRESS Pdmonds ��A
APPLICANT: PHONE. 7r 3
Indicate type or degree of interest in the property: owner
ADDRESS 22 Main St. pHONE175�„1�.
Wa
OMER: Born Thu
VEST THAT THE FOLLOWING DESCRIBED PROPERTY BE DIVIDED INTOLOTS. (Indicate No.)
REQ -'
} .:; ;:..... LEGAL DESCRIPTION OF ENTIRE PROPERTY s
nt
`+ To be completed by the Planning Departure
Use Zone . LEGAL DESCRIPTION .CHECKED Date& APPROVED
Kroll t�1ap No. 120E By
a
described property,
(i f CERTIFICATION: I do hereby certify that I own.the above lwhichyI own, which has not
and further, that all contiguous property
�•. '..received a previous subdivision approval, is in,luded herein.
I further certify that the attached list
ithinn
of all property owners w 300nfeetmof,
thedsub devi-
• and zip codes
' sion as recorded with the County Assessor.
I understand that street dedications may
be required in conformance
d ,
.—with the Official Street Plan of the City of Edmonds.
LE,ByAO7)
ty Owner
r attach a sketch of the proposed subdivision drawn to scale simi-
SKETCH: Show below o On subdivisions, where possible, indi-
ar to the example shown on the reverse side. ske
tch of
ca to location of existing septic tanks and drain fields.sketchescareeattached�, please sub -
the area per example shown on the reverse side. 1 s ro ert is divided
mit six copies. On subdivisions, attach a statement oreresont Wnformationynot appar-
in the manner shown, such as topography, or any other p
ent on the sketch.
See preliminary plat submitted herewith.