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„,i,,,,,:,...,„,,,f,-..__:” <br /> 3i <br /> LAND USE APPLICATION 'Ai S CC/ CAS c he 1�!rn4. e.;f� <br /> RE v.L - 'f7 I.7- <br /> 1) Name of Applicant J. T. Madison Inc. R-e ✓Pt - 0* 1 c;/ <br /> Address PO Box 31609 FOR OFFICIAL USE ONLY <br /> City Seattle state WA zip code 98103 TYPE: <br /> Phone (206) 619-5555 Alt ph FILE# . 0 OS <br /> Email toddmadison@hotmail.com FEES _____RECEIPT 11 ' _ <br /> 2) Primary Contact (if other than applicant) ASSIGNED TO: <br /> Address 6) I� C� L� O C� Fin <br /> City State Zip Code l 'J 1'► <br /> n <br /> Phone Alt ph <br /> Email <br /> I I <br /> 3) Property Owner(s) Madison Real Property LLC <br /> Address PO Box 31609 City Seattle state WA zip code 98103 <br /> 4) Project Address or Location 6502 Evergreen Way Everett, WA 98203 <br /> Tax Parcel No(s) 00393000001500,+ 00393000002900 Area of Property(acres/sq ft) •47/20,473 <br /> Zoning E-1 M� lr� L L.' Comprehensive Plan Designation <br /> 67,/,a[r.e el tfea-ViCe.S me.li/t. / <br /> 5) Brief Description of Project 7k sf 16 bed Assisted-b-ivir1gl lees-i-6/6upportive-leletIei+ig, <br /> 3k SF retail, 34 parking spots, related site improvements <br /> 6) Name of the planner who conducted or waived the Pre-Application meeting Teresa Weldon <br /> 7) Authorization: I am the owner or am authorized by the owner to sign and submit this application. I grant <br /> permission for City staff and agents to e,ter onto the subject property for the sole purpose of making any <br /> inspections of the property which are e •ssary to process this application. I certify under penalty of perjury <br /> of the laws of the State of W i : hat the information on this application and all information submitted i <br /> herewith is true, compl- �- <br /> �'� 02/03/17 <br /> signature /�i�//� Date _ <br /> Please print name -odd Madison 0 Owner 0 Applicant D Primary Contact <br /> City and State where this application is signed Everett WA <br /> City State <br /> www.everettwa.gov <br />