01635CITY OF EDMONDS
APPLICATION
for
PLANNED RESIDENTIAL DEVELOPMENT.
To be filled in by Planning 1
DATE b I O FILE # =3
FEE $ / c.3.3g Rec' t #
IN -LIEU PARK FEE $
Rec't #
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APO'S TITLE REPORT
COMPLETE LEGAL DESCRIPT.
MAP GRADING PLAN
ENV.ASSES. ✓CK'LIST ✓
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LAIDB FILE #
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APPLICANT92V=
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Phone
Zip Code
Address Z+0_1Z_
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Code
Address
Phone
Address
_Zip Code
LEGAL DESCRIPTION OF SITE
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EXISTING ZONE CLASSIFICATION
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PROPOSED ZONE CLASSIFICATION, if a change is being request'ed!!4/i/51/�
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TOTAL AREA OF PROJECT
NUMBER OF D14ELLING UNITS PERMITTED clude method of computation:
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NUMBER OF DWELLING UNITS PROPOSED Oki
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SigIrflature of owner(s)or Agent",
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Own Y S� B! J%E-r�Q
*Owner's authorization, b notarizeJsignature, is required for any application.'' �`
submitted by an agent.
(11/78)