825 MADISON ST 2016-01-01 MF Import

, ' , �- CITY OF E i�ERE7'� c, P�.ANNINGAND COli�MUNITYDEVELOPMEN�' LAND �TSE PERMIT APPLIC�4 TION ❑ Boundar}• Line Adjusunent ❑ Lot Ceriification ❑ Nonconforming UseJBuilding ❑ Planning Director's Review Process I Decision ❑ p)anning Direaor's Review Process iI Decision ❑ Rezone ❑ SF.PA ❑ S'aoreline ❑ Short Subdivision ❑ Special Propem Use: Review Proc�ss I ❑ Special Propem� Use: Review Process II ❑ Special Property Use: Revic�s Process III ❑ Subdivision ❑ Variance � ❑ Other Applicant Address Praperty Owner Address Primary Contact Address /'G, ('1LL: �R FOR OFFICE USE ONLY FEE S RECEIPT m r�'�� S�ru'�u�s �-�c • �.55,� . Et�e r� u. - n 9�� a c i_F; � s C L C�IC �S C- r' Uun appiinnt) Property Address or Location � Tax Identification NumberFl-D�l � - STAMP INDATE ;.� rz �� i� i�- ii 95�u:.3 it E' �. C�C c$C'/� ve�F ff u; P 9��c3 � /�'7nc��S��n _`fit. . � Legal Description c,�n J�K�> � o�i' 17. ('c, �f � �5�� mr -d7 Zoning i� L �ompreiien: Area of Property cn�vsq�� F�n� /_3Y�i `i �� ProjectDescription n f�a nc,v �s �c_ �i [�.. �,,..�, :!u_.t-� r,,.:.�'�� ,,.. /-:'� , = � -:, � Pian Designation !� Name of the planner who conducted the Pre-Application meeting c«:��a...+�R> Phon �S!�� 35�7-3�`�� _Fa�(y�513 7-c�1 '��- Phone I�/��3�' 7 -3/!�7" Phone(��5)3v'7-3/ �'�% _ Fa1x I y�5/ 3�/7•��• v9 Z 2° 7`/ 9�3l,-7 - C/7 -CGG,3 /�, 1i: ; � L'a�� I am the owner or am authorized by the owner to sign and submit this application. I¢rant permission for City staff and agents to en?er onto the subject property for the sule purpose of making any inspection of the property which is necessary to process this application. I certify under penalty of perjury of the laws of the State of Washington that the information on this application and all informaticn submitted herewith is true, complete, and correct. ' _ Signature by Owner/ApplicanUAeent y...:.c.�-� //�1=-�-- � Date %�/i �� 7 ; �� City and State where this application is signed �<-c_.i -t/_� Ce; r City State