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HomeMy WebLinkAboutA_MasterApplication_230217_v1DEPARTMENT OF COMMUNITY %
AND ECONOMIC DEVELOPMENT
Planning Division
;R
1055 South Grady Way, 6th Floor I Renton, WA 98057 1 425-430-7200
www.rentonwa.gov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: Vladimir Bejenari
ADDRESS:104 236 Place SW
clTY: Bothell
STATE:
IWA
ZIP:
198021
PHONE NUMBER: (206) 650-6372
EMAIL ADDRESS*:reklamamd@yahoo.com
I ❑ refer to receive all corres_ondence via US Mail.
APPLICANT (if other than owner)
NAME:
COMPANY (if applicable):
ADDRESS:
CITY:
STATE:
ZIP:
PHONE NUMBER:
EMAIL ADDRESS*:
❑ I prefer to receive all correspondence via US Mail.
CONTACT PERSON
NAME: Vladimir Bejenari
COMPANY (if applicable):
ADDRESS:
CITY:
STATE:
ZIP:
PHONE NUMBER
EMAIL ADDRESS*:
❑ I prefer to receive all correspondence via US Mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Tree Removal
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
10502 SE 166 Street
Renton, WA 98055
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
0087000022
EXISTING LAND USE(S):
Residential
PROPOSED LAND USE(S):
N/A
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
Residential medium density
PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable) N/A
EXISTING ZONING:
R-8
PROPOSED ZONING (if applicable):
N/A
SITE AREA (in square feet):
17,600
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
N/A
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED: N/A
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable) N/A
NUMBER OF PROPOSED LOTS (if applicable)
N/A
NUMBER OF NEW DWELLING UNITS (if applicable):
N/A
NUMBER OF EXISTING DWELLING UNITS (if applicable):
N/A
PROJECT VALUE:
N/A
*By completing the email address field the owner/applicant/contact person is opting to receive all formal notifications
and project documents in digital format via email unless otherwise requested.
PROJECT INFORMATION (CONTINUED)
ENNEWMN� 7
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable): N/A
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): N/A
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable): N/A
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): N/A
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable): N/A
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
NEW PROJECT (if applicfft:
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE
INCLUDE
SQUARE FOOTAGE (if applicable):
❑ AQUIFER PROTECTION AREA ONE
❑ AQUIFER PROTECTION AREA TWO
❑ FLOOD HAZARD AREA
sq. ft.
❑ GEOLOGIC HAZARD
sq. ft.
❑ HABITAT CONSERVATION
sq. ft.
❑ SHORELINE STREAMS & LAKES
sq. ft.
❑ WETLANDS
sq. ft.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included
C ITI IA1 1 AI1A/
• -•• UUAK i LK ur SECTION Ly TOWNSHIP 23 N, RANGE 5 E W.M. IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON —
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Vladimir Bejenari , declare under penalty of perjury under the laws of the State of Washington that I
am (please check one) E the current owner of the property involved in this application or ❑ the authorized representative to act for a
corporation (please attach proof of authorization) and that the foregoing statements and answers herein contained and the information
herewith are in all respects true and correct to the best of my knowledge and belief.
©2-
Sig ure of Owner/Representative Date Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF
� ;S�
Sq
I certify that I know or have satisfactory evidence that V IR Cl t I v"`^'- e'," A""
signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument.
Dated
JENNY MCFARLAND
Notary Public
State of Washington
Commission # 176076
My Comm. Expires Jan 19, 2027
Notary Public in and for the State of Washington
Notary (Prin�:
My appointment expires: