HomeMy WebLinkAboutA_Master_Land_Use_App_R2B_SSDP_171128_v1DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Planning Division
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)PROJECT INFORMATION
NAME: PROJECT OR DEVELOPMENT NAME:
ADDRESS:
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
CITY:ZIP:
TELEPHONE NUMBER:KING COUNTY ASSESSOR’S ACCOUNT NUMBER(S):
APPLICANT (if other than owner)
NAME: EXISTING LAND USE(S):
COMPANY (if applicable):
PROPOSED LAND USE(S):
ADDRESS:
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
CITY:ZIP:
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
TELEPHONE NUMBER:EXISTING ZONING:
CONTACT PERSON PROPOSED ZONING (if applicable):
NAME: SITE AREA (in square feet):
COMPANY (if applicable):
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
ADDRESS:
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
CITY:ZIP:
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
TELEPHONE NUMBER AND EMAIL ADDRESS:NUMBER OF PROPOSED LOTS (if applicable)
NUMBER OF NEW DWELLING UNITS (if applicable):
1
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 0 /2015
Print Form Reset Form Save Form
Washington State Department of Transportation
Bellevue 98004
(425)456-8586
Washington State Department of
Transportation (WSDOT)/I-405 Team
600 - 108th Avenue NE, Suite 405
Bellevue 98004
I-405 Renton to Bellevue Project, Stage 1
WSDOT ROW - no applicable parcel numbers
State Highway
State Highway
East of I-405 – Resource Conservation (May Creek Bridge)
West of I-405 – Residential 6 – 6 DU/AC (Lk Washington Trail)
N/A
N/A
N/A
N/A
N/A
Lake Washington - Shoreline of State Significance
May Creek - Shoreline
Cooley, Linda J.
600 - 108th Avenue N.E., Suite 405
Kimberly Toal
I-405 Team
600 - 108th Avenue N.E., Suite 900
Bellevue 98004
(425)450-2721 ToalK@consultant.wsdot.wa.gov
(425) 456-8586 (206) 769-7481
The project extends along I-405 for approximately 8 miles from
mile post (MP) 3.8 in Renton to MP 11.9 in Bellevue.
17.4 million
PROJECT INFORMATION (continued)
NUMBER OF EXISTING DWELLING UNITS (if applicable):PROJECT VALUE:
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable):
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):AQUIFER PROTECTION AREA ONE
AQUIFER PROTECTION AREA TWO
FLOOD HAZARD AREA
GEOLOGIC HAZARD
127,131_sq.ft.
HABITAT CONSERVATION
SHORELINE STREAMS & LAKES
WETLANDS
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable):
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable):
LEGAL DESCRIPTION OF PROPERTY (see attached sheet)
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE __________ QUARTER OF SECTION ____, TOWNSHIP ____, RANGE ____, IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
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 Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that 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 Notary Public in and for the State of Washington
Notary (Print):
My appointment expires:
2
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 0 /2015
N/A
N/A
N/A
N/A
N/A
N/A
X
X 7.6 mil sq.ft.
_______ sq. ft.
14,847____ sq.ft.
182,792 sq. ft.
N/A $890 million
Linda J. Cooley
X
X
X
X
¼ Section Section Township Range
NE ¼ 17 T23N R5E
SE ¼ to NW ¼ 8 T23N R5E
SW ¼ to NW ¼ 5 T23N R5E