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STATE OF WASHINGTON i <br />S.S. <br />COUNTY OF SNOHOMISH t <br />1, cwAaces 6 O GOEIV , being duly sworri, depose and say that I am the applicant for <br />a permit to construct a substantial development, conditional use or variance pursuant to the Shorelines <br />'Management Act of 1971. and that the following statements, answers and information are in all respects <br />true and correct to the best of my knowledge and belief. <br />Subscribed and swom to before me this —day of <br />(NOTARY SEAL) y a. BUG <br />p�V M�SStoN fa q'Ld, <br />NOTARY i , otar blic m1grid for the <br />'co o 2 State of Washington, residing at <br />9 2.t. ie <br />F_ .a� <br />