®A filing fee must accompany all Hearing's Official and Historic Review Board a eats. The fee . pp <br />vanes depending upon the type of application and is adjusted periodically by the City Manager. <br />Check with Planning staff at the Permit and Information Center to determine the required fee or <br />check on the web at: www,eu ene tannin .or <br />Acknowiedgment <br />I ewe}, the undersigned, hereby acknowledge that I ewe} have read the above appeal form, understand <br />the requirements for f ling an appeal of a Hearings Official or Historic Review Board decision, and <br />state that the information supplied is as complete and detailed as is currently possible, to the best of my <br />. dour} knowledge. <br />APPELLANT <br />Name (print}; ~ ~ . <br />N'ew Cingular wireless PCS, LLC, by AT&T Mobility Corporation, its Mana er <br />By; Richard J. Busch,lts attorney Phone: 425-458-3940 <br />Address: 22525 SE b4t~ Place <br />CitylStatelZip: Issaquah, wA 98027 . <br />Signature: <br />APPELLANT ~ <br />Name sprint}; ~ Phone. <br />. , <br />Address: <br />C~tylStatelZip: ~ ~ . <br />Signature; <br />r , <br />IF this appeal is being filed by the affected recognized neighborhood ~associatian, com lete the <br />followin ~ ~ p g. <br />Name of Association: ~ ~ . <br />. - <br />- ~ , <br />Appeal of Initial Hearing Official Page 2 of 2 <br />or Historic Review Poard Decision <br />. PC Agenda -Page 14 <br />