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` SUpLS... TO TryECfJ <br />P `fya, KZTTZTgB COUNTY <br />DEPARTMENT OF PUBLIC WORKS <br />KMMS COUNTY <br />ROAD STANDARDS VARIANCE APPLICATION <br />Application for: Road Variance $1,075.00 Payment Method: ❑ Check ❑ Cash t kredit Card <br />Owner Name Jackson Purcell Permit # \1 00 <br />Mailing Address PO Box 663 Easton Wa 98925 <br />Phone Number 253-301-7444 <br />Email Address_ iackson0121@gmaii.com <br />Applicant Name Lucas Nosetti <br />Mailing Address PO Box 105, Easton, WA 98925 <br />Phone Number 206.715.5853 <br />Email Address Iucasl02684@gmail.com <br />MAY 2'720��25aaN <br />TY <br />DATE S _ <br />Variance Request Information <br />Applicant to provide supporting documents and an area map. <br />1. Property Tax Parcel numbers: 111634 <br />2. Narrative project description: <br />?%ea--sL, <br />3. Provision of road standards for which this variance is requested and the way in which you wish <br />to vary from the standards: <br />Reason for the variance request: <br />4. Proposed Mitigation for requested variance: <br />5. Are there any other pending applications or issues associated with this property? <br />Yes x No If yes, describe: <br />Application is hereby made for permit(s) to authorize the activities described herein. I certify that I am <br />familiar with the information contained in this application, and that to the best of my knowledge and belief <br />such information is true, complete, and accurate. I further certify that I possess the authority to undertake the <br />proposed activities. I hereby grant to the agencies to which this application is made, the right to enter the <br />above -described location to inspect the pr9&sed and or completed work. C <br />Signature of Authorized Agent: ✓�� Date: <br />Signature of Land Owner of Record: �— Date: <br />411 N. Ruby St. Suite 1 TEL (509) 962-7523 <br />Ellensburg, WA 98926 FAX (509) 962-7663 <br />