HomeMy WebLinkAbout20260210_PJA26-0097_Application LAND USE APPLICATION
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ADMINISTRATIVE
CONDITIONAL USE PERMIT
COMMUNITY A ECONOMIC DEVELOPMENT
18204 5911 Avenue NE -Arlington„ WA 98223- Main Line 360.403.3551
PERMIT TYPE
Type of Permit ❑ Homeless Encampments Required Submittals W Administrative Conditional
❑ Temporary/Seasonal Use Use Application
D Mobile Sales and Deliveries ❑ Submittal Requirement
Checklist
El Required Submittal Items
SITE INFORMATION
ProjectfBusiness Name: Buzzy Bee Coffee LLC
UBI: 605491014
❑Vending Cart ❑Food Truck ❑ Ice Cream Truck W Mobile Espresso
Proposed Use: ❑ Retail Trailer ❑ Homeless Encampment ❑ Other(Please explain)
Other:
Offsite Storage Location Address: 13733 Smokey Point Blvd City,Marysville State:WA
If Applicable
Will you be utilizing the food truck court? ® Yes ❑ No ❑ NIA
#1.4620 172nd St NE, Arlington, WA 98223 ❑ NIA
Existing Business Use:no
Site Address/Addresses #2.
Please provide address for Fnl NIA
locations within City Limits Existing Business Use:
other than the food truck #3.
court,if applicable ® NIA
Existing Business Use:
#4:
NIA
Existing Business Use:
OWNER APPLICANT PRIMARY CONTACT
Name Stephnaie Leoso same same
12115 State Ave C209
Full Address
Marysville WA 98271
Phone Number (425)247-1808
E-mail buzzybeecoffee@outlook.com
Relationship of
Applicant to Property ®Owner ❑Lessee ❑Other:
check one
City of Arlington
Administrative Conditional Use Permit Application
Page 1 of 2
Rev 1/2025
APPLICANT CERTIFICATION
|certify that|am the Owner cx Owners authohzedogont, |f acting aoon authorized agent,!further certify that|mmauthorized
hu act aS the Owners agent regarding the property cd the above referenced address for the purpose o/filing applications for
permits or review under the Arlington Municipal Code and I have full power and authority to perform on behalf of the Owner all
acts required tn enable the City hz process and review such applications.
I do hereby declare under penalty of perjury under the laws of the state of Washington that I have familiarized myself with the
rules and regulations with respect to preparing and filing this application and that the statements and information submitted
herewith are in all respects true and correct to the best of my knowledge and belief,
1�� 1� ����� Ave, Marysville , �/������
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O/Q�DAT /«- ' '^^ ������ VVamhin�nnunUh�d�e�
ApplicanCoGignab8re----/
REAL PROPERTY OWNER CERTIFICATION
I do hereby declare under penalty of perjury under the laws of the state of Washington that I am the owner of the subject
property or an officer/member of the entity owning the subject property,that it is my desire to seek the subject land use permit,
and that I will abide by any requirements and conditions that may be part of the approval of this request. I also hereby grant
permission for City employees,agents nf the City and/or other agency offinia|sho enter the subject property, if necessary,for the
purpose of site inspections.
^���/��K���&�
12115 ��y�������u���
DATED AT .Washington un this date:
Owner's Sig'
All other property owners of the subject property must also sign below(attach additional sheets if necessary):
David U --
u�����U�� u_�������
D Name: ~~ ~ ^ ~"^~^~~~ Signature:
12115 ��e A�, MB 'U� �� �8271 K���� ���� —� � ��
A���� Marysville p��� ����� �� n ��x x �
2) Name Signature:
/dUmoa: Phone:
3) Name:
Address: Phone:
City of Arlington
Administrative Conditional Use Permit Application
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