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r.. <br /> :t =;_:>: <br /> x <br /> CITY OFEi�ERETT <br /> PLANNINGAND COMMUNITYDEYELOPMENT <br /> LAND USEPERMITAPPLICATION <br /> ❑ Boundary Line Adjustrnent <br /> ❑ Lot Certification UR OFFI[:E USEONLY <br /> ❑ Nonconfortniag UscBuilding <br /> ❑ Planning Director's Rcview Procrss I Dccision F7�'� � I/ � 99�DD/ : <br /> ❑ Planning Director's Revicw Process II Decision ,�.: �. <br /> ❑ Rezone ' <br /> FEE S ��� �✓�%"� RECFIPT# '' ;?"""i <br /> ❑ SEPA � � � � " <br /> ❑ S6orolinc -_-`�� (7�^ <br /> ❑ Slwrt Subdivision �� <br /> ❑ Special Property Use: Review Pracess I . MAY 2 7 '�99 <br /> ❑ Spocial Property Usc: Itcview Proccss Q <br /> ❑ Special Property Usc: Review Pracess 1II <br /> ❑ Subdivision CITY OF EV:RET'j` <br /> @'yar;a„� --�ermit-Seruisat <br /> ❑ Other STAMPINDATE , <br /> AppGcant_(�I-gr 5 �I- I�ia ren �rral ,Sty,•i Phone 2,y'g -2S 3�� <br /> Address�2 7 Gv !/(c.7�-br /°! -.d..,r �F Wi9- S'Fs.�l Fax �y g-2,93�_ <br /> Property Owner_� �� Phone <br /> Address � ' � - <br /> Primary Contact�Janaw,,,,R,ca„�� Phone <br /> Address �� F� <br /> Property Address or Location_ �Z 7.2(J' �fC�dr ��oca f CVere'{f �/�f�- g�2Cl'� <br /> Tax Identification Number j 5 3 f -D U g - Dl ti -D�l Oz <br /> iegal Descrip�tJ'on�.n,a�a��y�13���� �y„ r�L q fs f-�� a/ l �S,��e Y 8 <br /> X Zoning h- •�-- Comprehensive Plan Designation J <br /> AreaofPropercy�n�✓sqw,�Fa,� y� �9� Sp .�{- �-` <br /> ProjectDescription /�/er,� qq y��y� �N„ ����/� <br /> Name of the planner who conducted the Pre-Application meeting�a.��a.,�.;�a� <br /> � �� � � �b �" <br /> I am the owner or am authorized by the owner to sign and submit this app(ication. I grant permission for <br /> City staffand agents to enter onto the subject property for the sole purpose ofmaking any inspection ofthe <br /> property which is necessary to process this application. I certify under penalty of pequry of the laws of the <br /> State of Washington that the infortnation on this application and alI infortnation submitted herewith is true, <br /> complete, and correct. - <br /> Signature by OwnedApplicandAgen ,�.,�fj�i�� Date / �4 � <br /> City and State where this application is signed C��� -�(//� <br /> City State <br /> �`i �� <br />