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� I <br />City o ffifEverett <br />Planning &Community Development <br />ADMINISTRATIVE DECISION <br />APPEAL FORM (.- .i not alter form) <br />Kearine Eraminer Review <br />❑ Appeal of Review Process I Decision <br />❑ Appeal of Review Process II Decision <br />❑ Appeal of Application of Development Standards <br />❑ Appeal of Short Subdivision <br />❑ Appeal of Binding Site Plan <br />❑ Appeal of Administrative Shoreline Permit <br />❑ Appeal of Unlisted Usc Detennination <br />❑ Other <br />CONTACT INFORMATION <br />Name of Appellant 1✓I<`ri��'L^_ <br />ff applicable, list all a. <br />Name of Appellant #2 <br />below: <br />FOR OFFICAL USE ONLY <br />(7LE # <br />FEES /DD RECELrr, *67 <br />usiG ED TO.- <br />j CCC"EH � <br />1 NOV 0 9 LA nDl <br />CITY OF EVERETT <br />f 73 <br />Zip `RZ,13 <br />Address City ;•;+a1 r! f1 _State L(/fi Zip <br />Name of Appellant #3 Phone <br />Address City State Zip <br />Name of Appellant #4 Phone <br />Address City State Zip <br />Name of Appellant #5 Phone <br />Address City State Zip <br />DECISION REAVG APPE I LED (Attach Copy) r ° ^�� �'�n/ � ��Y'D d � 1'� � /�f i,•(/ ul <br />Project Number N/A Project Name J1 N1401rSr-� <br />Property Address or Location ,_ D r- n rhDr- T rl,— <br />Signature of Appellant (\ Date— <br />/fapplicable: <br />Signature of Appellant #2 Date <br />Signature of Appellant # Date <br />Signature of Appellant #4 Date <br />Signature of Appellant #5 Date <br />Pleasc Note: Policy requires that the appellant orthe appellant s rcnresentadve be present at the public hearing. <br />Tire burden o moo for all appeals provided for by the City gl'Everett Zoning Coale shall be upon the Appellant. <br />All appeals must beftded on fortns provided by the plannig ndeparhrrern and will not he considered valid unless the <br />appeal fin•rn is filled out clearly, completely, and legibly and is acconytanied by the applicable fec. ThisJorrrt shall <br />not be altered in any +vary. <br />