02065BOARD OF ADJUSTMENT DATE 3 _ - 9 9
APPLICATION FOR VARIANCE FEE o�S
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P.0•Q `� HEARING DATE:
APPLICANT �Q� \ awo.j ADDRESS �iT - - CW-� CITY &ZIP
PHONE'118-D2-OCo Indicate type or degree of interest in the property:1�
OWNER:
✓ ADDRESS,CITY & ZIP �n� f� = PHONE_
LOCATION OF PROPERTY(ADDRESS)
LEGAL DESCRIPTION OF PROPERY : 1TWA
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ZONING ORDINANCE REQUIREMENT:
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VARIANCE REQUESTED:_
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STATEMENT .OF CONDITIONS AND REASONS
FOR REQUEST,
IN ACCORDANCE WITH STANDARDS AND CRITERIA
ATTACHED:
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STATE OF WASHINGTON)ss.
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COUNTY OF SNOHOMISH
4 'gnature of Applicant erL6r Representative F
On this date, before me, the undersigned, a Notary Public ' and f r he State of
r. Washington, duly commissioned and sworn, personally appeared
,who, being r
duly sworn, on his/her oath deposes and says that +Qhe has pre are and a the foregoing
therein are true, and has
statements and has acknowledged to me that the recitations contained
r signed this instrument as his/44= free and voluntary act and deed for the purposes therei n
Y mentioned.'
Subscribed and sworn to before me thi sday of 19
residing at
Notary Public in and for the State of Washington.
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