01875CITY OF EDMONDS .
BOARD OF ADJUSTMENT
APPLICATION FOR VARIANCE
FILE # '
,DATE 1,0
FEE $25.00
REC' T # 111I.
HEARING DATE: '11_
APPLICANT:J ADDRESS 30 A�"ew
PHONE:�'�}— �703
Indicate type or degree of interest in the property:_ 6)6/
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OWNER: ADDRESS:
PHONE:
LOCATION OF PROPERTY (ADDRESS)
LEGAL DESCRIPTION OF PROPERTY:
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LE L DESCRIPTION CHECE &AIFPROVED
By Planning Department
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ZONING ORDI��A' CE REQUIREPIENT:
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VARIANCE REQUESTED: -
STATEMENT OF CONDITIONS AND REASONS FOR REQUEST, IN ACCORDANCE 14ITH STANDARDS AND CRITERIA f.
ATTACHED:
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STATE OF WASHINGTON)ss. S a ure of App i
nt, ner or Representative
COUNTY OF SNOHOMISH)
On this date, before me, the undersigned, a Notary Public 'n
and for th State of
Washington, duly commissioned and sworn, personally appeared
being duly sworn, on his/her oath deposes and says that (s)he has
�A � ,who,
prepared and read t fore- 4
going statements and has acknowledged to me that the recitations
free and voluntary act
contained therein are true, i
and deed for the purposes
and has signed this instrument as his/her
therein mentioned.
Subscribed and sworn to before me thi46a
ay of �-� 19
residing a�t�.�
y Pubnand or the State of lashington.