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HomeMy WebLinkAboutA_Master Application_180126_v1PROPERTYOWNER(S)NAME:CityofRentonADDRESS:1055SGradyWayCITY:RentonZIP:98057TELEPHONENUMBER:425-430-6600APPLICANT(ifotherthanowner)NAME:CityofRentonCOMPANY(ifapplicable):ADDRESS:1055S.GradyWayCITY:ZIP:98057RentonTELEPHONENUMBER:CONTACTPERSONNAME:ToddBlackCOMPANY(ifapplicable):CityofRentonADDRESS:S/ACITY:ZIP:TELEPHONENUMBERANDEMAILADDRESS:PROJECTINFORMATIONPROJECTORDEVELOPMENTNAME:RiverviewParkBridgeAbutmentProtectionPROJECT/ADDRESS(S)/LOCATIONANDZIPCODE:2901MapleValleyHighway,Renton,WA98057KINGCOUNTYASSESSOR’SACCOUNTNUMBER(S):162305-9033EXISTINGLANDUSE(S):IncorporatedCityPROPOSEDLANDUSE(S):N/AEXISTINGCOMPREHENSIVEPLANMAPDESIGNATION:ResidentialLowDensityPROPOSEDCOMPREHENSIVEPLANMAPDESIGNATION(ifapplicable)EXISTINGZONING:ResourceConservationPROPOSEDZONING(ifapplicable):SITEAREA(insquarefeet):200SFSQUAREFOOTAGEOFPUBLICROADWAYSTOBEDEDICATED:N/ASQUAREFOOTAGEOFPRIVATEACCESSEASEMENTS:N/APROPOSEDRESIDENTIALDENSITYINUNITSPERNETACRE(ifapplicable)N/ANUMBEROFPROPOSEDLOTS(ifapplicable)N/AH:’PARKSPLANNING\CapitalProjectCoordinator’ProjectsA-Z\RiverviewParkBridgeAbutmentEarthwork\ShorelinePermit\RiverviewParkBridgeAbutmentProtection-LandUseAppdoc-1-CityofRentonLANDUSEPERMITMASTERAPPLICATION08/17 F254306571tblack@rentonwa.govNUMBEROFNEWDWELLINGUNITS(ifapplicable):N/AH:WARKSPLANNING\CapimlProjectCoordinator\ProjectsA-Z\RiverviewParkBridgeAbutmentEarthwork\ShorelinePermit\RiverviewParkBridgeAbutmentProtection-LandUseApp.doc-2-08/17 PROJECTINFORMATION(continued)I,(PrintName/s)ToddBlack,declareunderpenaltyofpeiuryunderthelawsoftheStateofWashingtonthatIam(pleasecheckone)thecurrentownerofthepropertyinvolvedinthisapplicationor_X_theauthorizedrepresentativetoactforacorporation(pleaseattachproofofauthorization)andthattheforegoingstatementsandanswershereincontainedandtheinformationherewithareinallrespectstrueandcorrecttothebestofmyknowledgeandbelief._____________(25‘fSignatureofOWner/RepresentativeDateSTATEOFWASHINGTON))SSCOUNTYOFKINGCcv,c(yT-(jJe1vNUMBEROFEXISTINGDWELLINGUNITS(ifapplicable):N/ASQUAREFOOTAGEOFPROPOSEDRESIDENTIALBUILDINGS(ifapplicable):N/ASQUAREFOOTAGEOFEXISTINGRESIDENTIALBUILDINGSTOREMAIN(ifapplicable):N/ASQUAREFOOTAGEOFPROPOSEDNON-RESIDENTIALBUILDINGS(ifapplicable):N/ASQUAREFOOTAGEOFEXISTINGNON-RESIDENTIALBUILDINGSTOREMAIN(ifapplicable):N/ANETFLOORAREAONNON-RESIDENTIALBUILDINGS(ifapplicable):N/ANUMBEROFEMPLOYEESTOBEEMPLOYEDBYTHENEWPROJECT(ifapplicable):N/APROJECTVALUE:$3,235.00ISTHESITELOCATEDINANYTYPEOFENVIRONMENTALLYCRITICALAREA,PLEASEINCLUDESQUAREFOOTAGE(ifapplicable):lAQUIFIERPROTECTIONAREAONEAQUIFIERPROTECTIONAREATWOFLOODHAZARDAREA_____sq.ft.GEOLOGICHAZARD______sq.ft.HABITATCONSERVATION______sq.ft.XSHORELINESTREAMS&LAKES200sq.ft.WETLANDS______sq.ft.LEGALDESCRIPTIONOFPROPERTY(Attachlegaldescriptiononseparatesheetwiththefollowinginformationincluded)SITUATEINTHESWQUARTEROFSECTION_16_,TOWNSHIP_23N__,RANGE_05E_,INTHECITYOFRENTON,KINGCOUNTY,WASHINGTONAFFIDAVITOFOWNERSHIPSignatureofOwner/RepresentativeIcertifythatIknoworhavesatisfactoryevidencethatsignedthisinstrumentandacknowledgeittobehis/her/theirfreeandvoluntaryactfortheusesandpurposementionedintheDateDatedV-/t}NotaryPublicinandfort,tateofWashingtonH:\PARKSPLANNING\CapitalProjectCoordinator\ProjectsA-Z\RiverviewParkBridgeAbutmentEarthwork\ShorelinePermit\RiverviewParkBridgeAbutmentProtection-LandUseApp.doc-3-ClI08/17