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� � <br />�!`�� �fi �iPE�E�i' <br />P����J���a �n� �ifl������i'� ����L�����T�' <br />��'� LAND USE APPLICATION <br />W' I �� � �� l� ���-- <br />• Name of,4pplicant `� <br />Address t� % �,� �� �'� �� <br />City �i,�,=�� � State �✓�- Zip Code ��'��� <br />Phone C'��� �5�� ��� Alt ph <br />E m a i I f�.� ,��i�i�i � C�� ' c.� �=�.��E t� ��,�. <br />� Prlmary Contact (if other than applicant) <br />Address <br />City State Zip Code <br />Phone Alt ph <br />Email <br />� Property Owner(s) � � � ��0� <br />Address �a� �� -�"� �v� � City � � <br />FOR OFFIC/AL USE ONLY <br />. �- - <br />� <br />��- �!�� ��1�' ` <br />FEE $ , � � RECEIPT # <br />t i ; �'�! i � ;..__ ;: <br />Y � i ��' S f��� <br />!�� �-���L�� � �_,,. ; <br />F�. � E <br />�� � <br />$���� 9 ; <br />� �� fvi/��� � � �u��� ��..1 <br />�� <br />�� !�'i��� �;)'� � `�� �: � _� i. g. <br />eg�'��i�i �f� ���t'�i'!f� ::"�> <br />State '��' Zip Code � �� �°'� <br />• Property,4ddress or Location /' 9� � ����-�-- � ut- �''%�e�1"�J"/ �C� � ��� <br />Tax Parcel No(s) �G �� (�J���� �� Area of Property (acres/sq ft) g �� R� <br />Zoning j��i ��,.Ar �c� ��,i����rc. Comprehensive Plan Designation <br />t p . ( n <br />• Brief Description of Project <br />�� , � ��"L � '^ S�Gs'f-i �' �,�I�-1% �— �:�- i r � �' <br />� Name of the planner who conducted or waived the Pre-Application meeting <br />• 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 enter onto the subject property for the sole purpose of making any <br />inspections of the property which are necessary to process this application. I certify under penalty of perjury <br />of the laws r�f the State of Washington that the information on this application and all information submitted <br />herewith is true, corryplete, and co <br />Signature <br />a � � <br />Date � � <br />� <br />�� _� <br />Please pri4�t name ��p� � �� c J�-Sa � Owner � Applicant C�Primary Contact <br />City and State where this application is signed ���.-��� , (�` � <br />City State <br />29:s�? li'rl�.eii'1CaYs� e'-1,,�enue, 5!.�ite £-;� E�i;-rtti, i;V;l 9i3�01 ��;2�.:2.51.3i33. =a ,= �i�!:�.�5�.�sin7. �� dvtivtiv.evereitwa.or4 �s i1y�c4�tec1 �009 <br />