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( I, <br />( CITY OF EVERETT ' <br /> PLANNING AND COMMUNITY DEVELOPMENT <br /> LAND USE PERMIT APPLICATION <br /> ❑ Boundarv Line Adjusaneot <br /> 0 Lot Certification POR OFFICE USE ONLY <br /> ❑ Nonconfomiing Use/fiuilding <br /> ❑ Planning Director's ileview Process I Decision FILE��,� 1�-96 <br /> ❑ Planning Dircctors Review Process Il Decision 00 = RECF.IPT#/Z�°bf <br /> 0 Rczone FEE S Z <br /> ❑ SEPA ^ <br /> O Shoreline n � � �O � � � <br /> ❑ Short Subdivision � �� <br /> p Special property Use: Review Process I � a .199s <br /> ❑ Special Property Use: Review Procas I[ � JUL r, ., <br /> ❑ Special Property Use: Review Process III <br /> ❑ Subdivision ''ITY OF GV�RETT <br /> ❑ Variance � � 5/�11�IPPS9 :p . <br /> �Other�(� ��— <br /> Applicant J "S" t � . ��!���� ^'� t Phone � s� - �> �(. <br /> Address �l/ C' �r��� czA �< Fax 2 S1- - (L' G' 7 3 <br /> � - � ? '� <br /> Property Owner SPss ! A ! - (�i /-t � S Phone � 3' ! <br /> Address / * ' ?� <br /> Phone �. 5 2 ' `���`"! <br /> Primary Contact pran�.�n.�.rri�wn) /�rT� P `� � F� � �2 - � 1:' > t <br /> Address S A, �n-t �F <br /> Property Address or Location %�> i � /?� �!'�� "��/ <br /> Tax Identification Number � ?.±',� ` ' � �j ' G � > - U G'O ? _ <br /> Legal Description�.�,�+a��r� �-c/' a�"'���-'�•�i <br /> Zoning �" `�' Comprehensive Plan Designation ���M� � u S� _ <br /> Area of Property c�+rsv�..�Fm) ' " � <br /> Pro'ect Description 2Gf 0 f F. <br /> Name of the planner who conducted the Pre-Application meeting c«�+v�w•��> � A�:A W�3 <br /> I am the owner or am authorized by the owner to sign and submit this application. I grant pertnission for <br /> City staff and agents to enter onto the subject property for the sole purpose of making any inspection of the <br /> property which is necessary to process this application. [ certify under penalty of perjury of the laws of the <br /> State of Washington that the infortnation on this application and all information submitted herewith is true, <br /> complete, and correct. � <br /> Signature by OwnerlApplicant/Agent _ , � '�-' � ~ Dat� �'1 �� � � <br /> City and State where this application is signed �� l r % '� � � <br /> ���y State <br /> eP 2930 Wetmore, Ste 100, Everett, WA 98201 S (206)259-8731, Fax (206)259-8742 <br />