Laserfiche WebLink
LAND USE PERMIT APPLICATION <br /> CITY OF EVERETT PLANNING DIVISION <br /> EVERETT INSTRUCTIONS: Com Oete form ,sign, and date. <br /> WASHINGTON See applicable land use application packet for all required checklist item s <br /> CONTACT INFORMATION <br /> APPLICANT Perm t Pursuers <br /> ADDRESS bb18 292nd 5t 5 <br /> CITY Kqy TATE W A Z IP 9858U <br /> PHONE 2--t3-215-UU84 MAIL perm ts(co perm tpursuers.Com <br /> OWNER LVLKL 115(:HUUL U151 1 <br /> ADDRESS 4/3U CULBY AVL <br /> CITY Lvprett TATE W A Z IP 982U3 <br /> PHONE E M AIL <br /> PRIM ARY CONTACT:El APPLICANT ❑ OW NER ❑ OTHER, PLEASE SPECIFY BELOW <br /> NAM E <br /> PHONE E MAIL <br /> PROJECT SITE INFORMATION <br /> ADDRESS /bZ1 BLVLKLY LN <br /> PARCEL NO(S) 28050700300400 <br /> PROJECT INFORMATION <br /> PROJECT NAM E Evergreen IVI Iddle School <br /> PROJECT Installation of (1) Electronic M iddle School <br /> DESCRIPTION <br /> VALUATION b3UU <br /> Authorization: I am the owner or am authorized by the owner to sign and subm t this application. I certify under penalty <br /> of perjury of the laws of the State of Washington that the inform ztion on this application and all inform ation subm tted <br /> herewith is true, com Mete, and correct. <br /> SIGNATURE ATE U9/14/23 <br /> PRINT NAM E j nn VV enaiana <br /> CITY, STATE KOY, VV H <br /> O2930 Wetm cre Ave, Ste 8-A © 425.257.8731 O planning@everettwa.gov <br /> Everett, WA98201 425.257.8742 fax everettwa.gov <br /> UPDATED 2021 <br />