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<br /> PLANNINGAND COMMt'11VtTYDEVELOFMENT �
<br /> LAND USE PE,RMIT APPL1'GATION •
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<br /> ❑ LotCertification � rr, G � .,,�z, i�x:�a=�=; ,;�`� ;,"'�::
<br /> FOR OFFICE I1SE ONLY- " �c.
<br /> ❑ Nonconfomting UselBuilding < � 'i;��;`
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<br /> ;R�Planning Dira-tni s Rcview Process II Decision ' : � � ,; � �� ,-� � �
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<br /> ❑ Short Subdivision � ' ` "� �
<br /> ❑ Special Propeny Uso:Review Process i ` , " 't : a�L� � ' w :
<br /> � Spaial Propecty Use, Review Process II � ` , , ? YF , • °^�`'` ' '`;
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<br /> ApplicantG'=1 C-G . ' ',U . Phona�.��'�SS��
<br /> Address r.`�. �. — ")j� /t=,. � r. Fax7'Eo<1.-35.�1[�7
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<br /> Primary Contect ry'anxuu�.wi;�n� J Phone
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<br /> Properry Address or Location/<1�� ,f��'r'cGY�GLC-�/ .�r�z'�2.`7�
<br /> TaxIdentificationNumber ���,j�%?f;.i'•"i'�.� �i`•�-�1'J��
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<br /> Legai Description�.mav��.�y� •
<br /> Zoning i�z=.S Compreliensive Plan Designation
<br /> Area of Property�,ws,sywre F�� �°%`��'
<br /> ProjectDescription ��T .�a-� •=<�c- ,•�� i�ti � � � C�-
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<br /> Name of the planner who conducted the Pre-Application meeting�a.+opa�..�wr>
<br /> I am the owner or am authorized by the owner to sign and su6mit this appiication. I grant perntission for
<br /> City staf£and agents to enter onto thc subject properry for the sole purpose of making any inspection of the
<br /> property which is necessary to process this application, I certify under penalty of perjury of tht laws of the
<br /> State of Washington that tye information on this application and all information submitted herewith is true,
<br /> complete, and corcect.
<br /> •��/�/./�'-�,� Date %� � >7
<br /> Signature by Owner/ApplicandAgent i ' �/l� �'�'
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<br /> City and 5tate whcre this application is signed':" .' �!7C:� ��Z ��2�-C_-
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