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A_RenLSFM_Cottonwood_Master_Application_230601_v1
CITYOFRENTONIPERMITCENTERLANDUSEPERMITMASTERAPPLICATIONNAME:CityofRentonPHONE:MichaelA.BenoitMAILINGADDRESS:1055SGradyWay,Renton,WAEMAIL:425-430-7206DIprefertoreceiveallcorrespondenceviaUSmail.APPLICANT(ifotherthanowner)NAME:MichaelA.BenoitCOMPANY(ifapplicable):CityofRentonPHONE:425-430-7206EMAIL:Mbenoit@rentonwa.govMAILINGADDRESS:1055SGradyWay,Renton,WA980580IprefertoreceiveallcorrespondenceviaUSmail.CONTACTPERSONNAME:MichaelA.BenoitCOMPANY(ifapplicable):CityofRentonPHONE:425-430-7206EMAIL:Mbenoit@rentonwa.govMAILINGADDRESS:1055SGradyWay,Renton,WA980580IprefertoreceiveallcorrespondenceviaUSmail.PROJECTINFORMATIONPROJECTORDEVELOPMENTNAME:CottonwoodLiftStationImprovements(RentonLiftStationandForceMainImprovementsPhase3)PROJECT/ADDRESS(ES)ANDPARCELNUMBERS:2101MapleValleyHighway,Renton,WA,TPN1723059103EXISTINGLANDUSE(S):OfficeBuildingPROPOSEDLANDUSE(S):N/AEXISTINGCOMPREHENSIVEPLANMAPDESIGNATION:CommercialOffice/ResidentialPROPOSEDCOMPREHENSIVEPLANMAPDESIGNATION(ifapplicable):N/AEXISTINGZONING:CommercialOffice/ResidentialPROPOSEDZONING:N/ASITEAREA(insquarefeet):1,710theareaweholdeasementrightsover-projectsite(81,587overalllotsize)SQUAREFOOTAGEOFPUBLICROADWAYSTOBEDEDICATED:0PROPOSEDRESIDENTIALDENSITYINUNITSPERNETACRE(ifapplicable):QNUMBEROFPROPOSEDLOTS(ifapplicable):0NUMBEROFNEWDWELLINGUNITS(ifapplicable):0NUMBEROFEXISTINGDWELLINGUNITS(ifapplicable):0PROJECTVALUE:$55,000SQUAREFOOTAGEOFPROPOSEDRESIDENTIALBUILDINGS(ifapplicable):0SQUAREFOOTAGEOFEXISTINGRESIDENTIALBUILDINGSTOREMAIN(ifapplicable):N/APROPERTYOWNER(S)rentonwa.gov/permitcenterIpIanningcustomerservice@rentonwa.govI425-430-72942/16/2023IPage1of2 LANDUSEPERMITMASTERAPPLICATIONLEGALDESCRIPTIONOFPROPERTY(Attachlegaldescriptiononseparatesheetwiththefollowinginformationincluded)SITUATEINTHESEQUARTEROFSECTION_17,TOWNSHIP23N,RANGE5__ . ,W.MINTHECITYOFRENTON,KINGCOUNTY,WASHINGTONAFFIDAVITOFOWNERSHIPMichaelA.BenoitI,(PrintName/s)_ _ _ __ __ ,declareunderpenaltyofperjuryunderthelawsoftheStateofWashingtonthatIam(pleasecheckone)thecurrentownerofthepropertyinvolvedinthisapplicationortheauthorizedrepresentativetoactforacorporation(pleaseattachproofofauthorization)andthattheforegoingstatementsandanswershereincontainedandtheinformationherewithareinallrespectstrueandcorrecttothebestofmyknowledgeandbelief.,___ _ ___ _ _ ___ _ _ ___ _ _SignatureofOwner/RepresentativeDateSignatureofOwner/RepresentativeDateSTATEOFWASHINGTON)SSCOUNTYOFKINGIcertifythatIknowovesatisfactoryevidencethat____________________________signedthisinstrumentandacknowledgeittobhis!eirfreeandvoluntaryactfortheusesandpurposementionedintheinstrument.SQUAREFOOTAGEOFPROPOSEDNON-RESIDENTIALBUILDINGS(ifapplicable):0SQUAREFOOTAGEOFEXISTINGNON-RESIDENTIALBUILDINGSTOREMAIN(ifapplicable):N/ANETFLOORAREAONNON-RESIDENTIALBUILDINGS(ifapplicable):N/ANUMBEROFEMPLOYEESTOBEEMPLOYEDBYTHENEWPROJECT(ifapplicable):QISTHESITELOCATEDINANYTYPEOFENVIRONMENTALLYCRITICALAREA,PLEASEINCLUDESQUAREFOOTAGE(ifapplicable):AQUIFERPROTECTIONAREAONE0AQUIFERPROTECTIONAREATWOFLOODHAZARDAREA50SOFT.SHORELINESTREAMS&LAKES1,710SQ.FT.GEOLOGICHAZARD1,710SQ.FT.LiWETLANDS__ _ __ _ __ _ __ __ _SQ.FT.0HABITATCONSERVATION____ _ _ _ _ _____SQ.FT.DatedMyappointmentexpires:L3—rentonwa.gov/permitcenterIpIanningcustomerservicetrentonwa.govI425-430-72942/16/2023IPage2of2