(Date stamp

CITY OF ."""'11

11930 Cyrus Way Mukilteo, WA 98275Fax (425) 212-2U6!l

PPR#SEPA#:-:-----r-----

Mise # ----, _I

Land Use Permit Application

Phone:

Y'v\t- \l"f~tJ I ~ 49:7"/.,1 r;42.t; 2.~0$'St$ Phone: 4~;; :121 ~f>3 S-

Project Address: 200 1':IlI::Jl-~u~ I'}lT I:WJ2 $.w Milk! f,1D ,W!l'rl 'l&7E.Legal Description of Property: l~ ftU'fBl,,Ti lS ki¥ATEt> kr2J[o ~lIg p",,,r EUIP$\.4 MIJ"" L'f'~, '\ ~2.75"' ~\"\ ..hN T~~~' ,f -r~ NW '.4 ~~1l~ '2..7( TIU'tJ.s~p zv,t4,

I l~ ~"f," Md~ &lTP sNDttot\t ,s-ij uv~, WAKey Contact Person: -f't1AlA eoU~AMAl1A~ Phone: ---4LS 2.be> 3 a g.3

Fax: ---------------------------

Owner:

Address: Address:

Applicant:

Project Type: .o Commercialo Multi-Familyo Industrialo Shoreline* (JARPA)o Conditional Use*o Variance*

o Preliminary Subdivision* 0 Special Use Permit*o Final Subdivision* jg Reasonable Useo Preliminary Short Plat* 0 Lot Line Adjustment*o Final Short Plat* 0 Grading*o Sector Plan Amendment 0 Binding Site Plano Waterfront Development 0 Project Rezoneo Single Family Residence 0 Other, Specify _

* Need to fill out supplemental application form with project.

Project Resume:

Existing Use: Vo..c.cc.~I

Total Site Area: "5,()()tJ ~tfr

Building Foot Print Area:J~~~fl

Lot Coverage: 7·~h (.No. of Parking Stalls Provided: 2-$'

Comp Plan Designation: Ct7MJltlrc: ~ I

Proposed Use: !1t::'~etJe-Water District: Av~

Sewer District: kW~vCJ1::" P

# of Proposed Units: "'/ABuilding Height: _?/~r;:...l__~~:...\_" _Zoning: C8 (s)

)

Gross Floor Area by Uses: ~ ~'1'Electric Vehicle Charging Units Provided: Yes __ No..X... If Yes, How Many? \J fA

i

Solar Panels being installed: Yes No.~ lfYes, How Many

Pre-application Meeting Held: <(j)N; date) __ A"'UL·~:..=~=-=U...::~..c:r!....-_'2.I?=-~15:::._- _

The information given is said to be true under the penalty of perjury by the laws of the State ofWashington.

tJ~/rp I IbDate I

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I O:\FORMS - New 2009\Land Use Permit Application.doc