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5009 COLBY AVE 2018-01-02 MF Import
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5009 COLBY AVE 2018-01-02 MF Import
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Last modified
4/14/2022 8:45:20 AM
Creation date
1/27/2017 3:57:11 PM
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Template:
Address Document
Street Name
COLBY AVE
Street Number
5009
Imported From Microfiche
Yes
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Authorization for home modiflcation <br />a/io/zoii <br />Scott C. Ellis (Property Owner) <br />5009 Colby Ave. <br />Everett, WA 98203 <br />C+!U���U <br />RE: Letter Requestlny Authorization ta modify property / home to meet requlrements jor utiliziny the <br />property/ home as o Ncensed AFH Adult Family Home <br />To whom it may concern: <br />I Scott C. Ellis the legal owner of above said property do herby grant Bruce Houghton permission to <br />conduct, modify or change the properry and or home (in accordance with any state or federel laws) <br />required to meet or exceed the requirements set forth by the above named organizations to establish <br />the property as a licensed Adult Family Home (AFN�. <br />Sinr,erely, <br />Scott C. Ellis <br />This authorization is valid for (365) days from the date of my signature below. Please keep a <br />copy of my release request for your files. <br />Thank you in advance for your cooperation. <br />r— -: - , <br />Signatur �' V-r�+ -- _ Date: � �� � � <br />Address: SfO�� �7�'`/'c ,�£. fi+.v.�sc•.//� .r) 91�>6 <br />Telephone (day): �?s �'�`�F-�`�3 � <br />
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