Exhibit 21 - Application.pdfcity of edmonds
land use application
ARCWTECTURAL DESIGN REVIEW FOR OFFICIAL USE ONLY
CONIPRE14ENSIVEPLAN AMENDMENT
CONDITIONAL USE PERN11T FILE # y ` J_ ZONE
HOME OCCUPATION DATE -7, 1-7,0 ,' REC'D BY
x FORmALSUBDIVISION FEE S. 00 RECFIPT4 0'7-313DO
SHORT SUBDIVISION
LOT LINE ADJUSTMENT HEARING DATE
PLANNED RESIDENTIAL DEVELOPMENT HE STAFF PB ADB CC
OFFICIAL STREET MAP AMENDMENT
STREET VACATION
REZONE
SHORELINE PERMIT _— CCW1544J,0-ted
VARIANCE I REASONABLE USE EXCEPTION
OTHER:
PROPERTY ADDRESS OR LOCATION 24223 76th Ave. W. Edmonds, WA 90026
PROJECT NAME (IF APPLICABLE) Hill Lake Ballinger
Ava Patterson Trustee
PROPERTYOWNER Laurie Hill & Kathy Maag PHONE# Laurie: 206-330-1936
ADDRESS 24223 76th Ave. W Edmonds, WA 90026
E-MAIL ADDRESS laurie.hill®internationalpaint.com FAX # 205-762-5239
00488800601503, 00488800601502
TAx ACCOUNT# 0.0488800601501, 0048680070200 SEC. 32 Twp. 27 RNG. 04
DESCRIPTION OF PROJECTOR PROPOSED USE To develop 4 parent parcels on Lake Ballinger
into an 6 lot plat.
APPLICANT Laurie Hill PHONE206-330-1936
ADDRESS 24223 76th Ave W. Edmonds, WA 98026
E-MAIL ADDRESS laurie.hill@internationalpaint.cum FAX # 205-762-5239
Tobiason & Company, Inc.
CONTACTPERSON/AGENT Laurey Tobiason PHONE# 206-429-2675
ADDRESS 20434 10th PL SW, Seattle, WA 981&6-4106
E-MAILADDRESS laureywTobiason.biz FAX 20G-824-1133
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application
agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including
reasonable attorney's fees, arising from any action or infraction based in whole or part upon false, misleading,
inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitt9hare true and correct to the be t of my
knowledge and that I am authorized to filp this application on the behalf f t o - er as listed b o
SIGNATURE OF APPLICANT/AGENT DATE -
Property Owner's Authorization
By my signature, I certify that i have authorized the above Applicant/Agent to apply for the subject land use
application, and grant my permission for the public officials a the staff ofthe City of Edmonds to ente the subject
property for the purposes of'nspection and'posting attend t this lication.
SIGNATURE OF OWNER %� DATE J " 1
This application form was revised on 1127100. To verify whether it is still current, call (425) 771-0220.
EXHIBIT 21
P-08-46 & SM -08-47
L: LIBRAKYTLANNIi iGTorins & HandoutsTubiie HandoutslLand Use Application.dec
city of edmonds
land use application"
ARCHr'ECTURAL DESIGN REVIEW FOR OFFICIAL USF ONLY
COMPF EHENSIVE PLAN AMENDMENT
CONDP'IONAL USE PERMIT PILE # ZONE
HOME OCCUPATION DATE REC'D BY
x FORMAL SUBDIVISION FEE RECEIPT#
SHORT SUBDIVISION
HEARING DATE
LOT LI 4E ADJUSTMENT
PLANN 3D RESIDENTIAL DEVELOPMENT HE STAFF PS ADB GC
OFFICI. LL STREET MAP AMENDMENT
STREET VACATION
R.EZON
SHOREMNE PERMIT
VARIANCE / REASONABLE USE EXCEPTION
OTHER
PROPERTY ADDRESS OR LOCATION 24223 76th Ave. W. Edmonds, WA 98026
PROJECT VAME (IF APPLICABLE) Hill Lake Ballinger
Ava Patterson Trustee Laurie; 206-330-1936
PROPERTY _)WNER Laurie Hill & Kathy Haag PHONE#
ADDRESS -4223 76th Ave. W Edmonds, WA 980215
E-MAIL AD3RFSS laurie. hillointernationalpaint. cam FAX # 206-762-5239
00488800601503, 00488800601502
TAXACCOINT# 00488800501501, 0048880070200 SFS 32 TWp 21 RNG. 04 .
DESCRIPTION OF PROJECT OR PROPOSED USE To develop 4 parent parcels an Lake Ballinger
into an 8 lot plat_
APPLICAN•- Laurie Hili PHONE# 206-330-1936
ADDRESS =4223 76th Ave W. Edmonds, WA 98026
E-MAILAI.DRESS laurie.hilleinternationalpaint.com FAX4206-762-5239
Tobiason & Company, Inc.
CONTACT 'ERSON/AGENT Laurey Tobiason PHONE# 206-429-2875
ADDRESS ,.0434 10th PL SW, Seattle, WA 98166-4106
E-MAILACDRESS laurey®Tobiason.bia FAX# 206-B24-1133
The undersigned applicant and his/her/its heirs, and assigns, in consideration on the processing of the application
agrees to rt -lease, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including
reasonable attorney's fees, arising from any action or infraction based in whole or part upon false, misleading,
inaccurate � it incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewi submitted are true and correct to the best of my
knowledge and that I am authorized to 9ie this application
on t e b half o he owner as listed b low_ �}
SIGNATURI OF APPLICANT/AGENT DATE -! - �� N ��✓
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use
application and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject
property fo - the purposes of inspection
�and
,.posting attendant to this application.
SIGNATURI OF OWNER 2COAtgADATE S - 2.2. •- 2 R
This application form was revised on 1117/00- To verify whether it is still current call (425) 771-0220.
L.\LIBR'.RY%PLANNIN(AFonns & HandoWsTublic HandaatsV and Use Apyfimuan.doc
AMENDMENT NO.1
SIGNING DATE:� '� OR -
TO -TO
THE AVA PATTERSON TRUST
TRUSTOR: AVA MARY PATTERSON
TRUSTEE: AVA MARY PATTERSON
NAME OF TRUST. The Ava Patterson Trust, dated July 16, 2001
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS, Ava Mary Patterson, as Trustor and as Trustee established a Revocable
Living Trust on July 16, 2001; and
WHEREAS, on December 7, 2001, the Trustor executed The First Amendment to the
Ava Patterson Trust; and
WHEREAS, said The Ava Patterson Trust continues in full force and effect; and
WHEREAS, pursuant to the provisions of Paragraph 3.2 of Article III of The Ava
Patterson Trust dated July 16, 2001, entitled "Rights Reserved by Grantor", the Trustor reserves
the right to amend in whole or in part, or to revoke in whole or in part, The Ava Patterson Trust
if done mi writing with written notice to the Trustee; and
WHEREAS, the undersigned as Trustor, hereby elects to amend The Ava Patterson Trust
as hereinafter provided;
NOW THEREFORE, SAID TRUST IS HEREBY AMENDED AS FOLLOWS:
FIRST: Paragraph 4.1.1 is revoked in its entirety and the following is substituted
°°Ff°roRiciNat
1
Q\212331020OW3)a117 diva 1st Trust Amend.doe
for a period of at least sixty (60) days, or inability of the Grantor to serve as Trustee, then
Laurie A. Hill and Kathy L. Maag shall serve as Successor Co -Trustees. If at any time
none of the above mentioned individuals named in this section will not or cannot serve in
their capacity as Successor Trustee, then a Successor Trustee may be chosen by the
beneficiaries of this Trust. If the beneficiaries cannot unanimously agree on a Successor
Trustee, the court shall appoint one. Said Successor Trustee shall be relieved of any and
all liability for any acts or omissions of the predecessor Co -Trustees in respect to
administration of this Trust. The Grantor directs that no individual, while serving as
Trustee hereof, shall be required to provide any bond or other security to insure the
faithful performance of their duty as Trustee hereof.
Except as specifically modified hereinabove, the Trustor hereby reaffirms all of the
remaining terms and provisions of The Ava Patterson Trust dated July 16, 2001, which has
remained in full force and effect since its date of execution.
Executed in duplicate at Seattle, Washington on ��, (� , 2003.
Ava Mary Patterson, 4rustor
Address: 24223 76th Avenue Nest, Edmonds, Washington 98026
2
Q: 212351020W\03MI? Ava istTrust Awerd.doc
APPROVAL OF TRUSTEES
The foregoing Amendment is hereby approved by the Trustee.
Ava Mary Patt son, Trustee
APPROVED BY:
Mullavey, Prout, Gfpnley.& Foe LLP
By -
Richar L. rout
Attorneys for Trustor and Trustees
ACKNOWLEDGEMENT
STATE OF WASHINGTON )
) ss.
COUNTY OF KING �
On this day personally appeared before me Ava Mary Patterson to me known to be the
individual described in and who executed the within and foregoing instrument, and
acknowledged that Ava Mary Patterson signed the same as her free and voluntary act and deed,
for the uses and purposes therein mentioned.
GIVEN under my hand and official seal this 23i --day of 2003.
NOTARY PUBLIC in and for the State
1►�!' `
of Washington.
Printed name:
.,
�A. Z o ;
'% `f.,• b-��_ 4;�__ My Commission Expires:
rpt, 8 4TE OF��` ~
QM 23 i102001d103Ju! 1.? Ava tst Trust Amend-doc
HILL LAKE
00488800601503
00488800601502
00488800601501
00468800702000
1/ 1/
BALLINGER
SW 4 , SW 4 , SEC. 32, T. 27N., R. 4 E., W.M.
LW& QESCRIMON
LOTS 20 AND 21, BLOCK 7, AND LOT 15, BLOCK 6, LAKE BALLINGER LAND CO'S
PLAT SUBDIVISION NO. 1, INCLUDING THAT PART OF VACATED BRADLEY ROAD LYING
BETWEEN SAID LOT 15, BLOCK 6, AND LOTS 20 AND 21, BLOCK 7, ACCORDING TO
-THE -PLAT THEREOF, RECORDED IN VOLUME -9 OF PLATS, PAGES 57 AND 58,
RECORDS OF SNOHOMISH COUNTY, WASHINGTON;
TOGETHER WITH SHORELANDS ADJACENT TO SAID LOTS 20 AND 21, BLOCK 7,
EXCEPT ANY PORTION THEREOF LYING SOUTH OF FENCE LINE ESTABLISHED IN
SNOHOMISH COUNTY SUPERIOR COURT CAUSE NO. 41910.
SITUATE IN THE COUNTY OF SNOHOMISH, STATE OF WASHINGTON.