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HomeMy WebLinkAboutA_Master Application_Patekar RVMP_230706.pdf%. CITY OF RENTON f PERMIT CENTER i� LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) NAME: Patekar MAIUNGADDQESS: 16024 SE 141st PI (Renton, WA) 98059 E3 I Prefer to receive all correspondence via US mail. APPLICANT (if other than owner) NAME: PHONE: MAILING ADDRESS: 5101 S 372nd St (Auburn, WA) 98001 0 I prefer to receive ail correspondence via US mall. CONTACT PERSON NAME: Christine Leonard PHONE: (206) 909 _ 2170 MAILING ADDRESS:5101 S 372nd St (Auburn, WA) 98001 © 1 prefer to receive all correspondence via US mail. PROJECT INFORMATION PHONE: EMAIL: COMPANY (if applicable); Pacific Arboriculture EMAIL:Office@ pacificarboricu Iture.com COMPANY (if applicable); EMAIL Offce@pacificarboricufture.com 1 �nnlniwstomerservice�rentQnwa.cov 1 425-430-7294 2/16/2023 I Pap 1 of 2 LAND USE PERMIT MASTER APPLICATION SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): SQUARE F00TAG1 OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (If applicable): NET FLOOR AREA - -- - EA ON NON-RESIDENTIAL BUILDINGS (if applicable): NUS OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROTECT (If applicable): 13 AQUIFER PRO ECTIOT N AREA ONE ❑ FLOOD HAZARD AREA _ GEOLOGIC HAZARD _ HABITAT CONSERVATION AQUIFER PROTECTION AREA TWO SQ. FT. O SHORELINE STREAMS & LAKES SQ. FT. ❑ WETLANDS SQ. FT. LEGAL DESCRIPTION OF PROPERTY (Attach legal description on separate sheet with the following information included) SITUATE IN THE QUARTER OF SECTION , TOWNSHIP N, RANGE W.M IN THE CITY OF RENTON, KING COUNTY, WASHINGTON SQ. FT. SQ- FT, AFFIDAVIT OF OWNERSHIP M�'" "-\0 Pa�e-kaY I, {Print Name/s) _ , declare under penalty of perjury under the laws of the State of Washington that I am (please check one) 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. Signature of Owner/Representative Date STATE OF WASHINGTON ) ) SS COUNTY OF KING I Signature of Owner/Representative Date I certify that I know or have satisfactory evidence that M( U"'\01` Q P-N(- 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. C9512oJ2a23 �?� '-�- Dated No is i d fo a State of Washington Z- Q ``\\\111141111 / _ loke''4,y Notary (Print): J U OTAy� 23012312t"' iN9'+1i 09 ��.'� 40 = My appointment expires: O C4 1OF WAS\A\�-11-� rentanwa. ov lannin customerservice rentonwa. ov 1 425-430.7294 2/16/2023 1 Page 2 of 2