HomeMy WebLinkAbout1_A_Application_Form_For_Land_Use_Permit_171102DEPARTMENT OF COMMUNITY ` CITY OF
AND ECONOMIC DEVELOPMENT ��— Renton
Planning Division
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME:
Sapphire Homes Inc.
ADDRESS:
16834 SE 43rd street
CITY: ZIP:
Bellevue 98006
TELEPHONE NUMBER:
425 818-8829
A APPLICANT (if other than owner)
NAME:
Travis Kassebaum
COMPANY (if applicable):
Sapphire Homes Inc.
ADDRESS:
16834 NE 43rd Street
CITY: ZIP:
Bellevue 98006
TELEPHONE NUMBER:
(206) 484-4321
CONTACT PERSON
NAME:
Travis Kassebaum/ Troy Schmeil
COMPANY (if applicable):
Sapphire Homes Inc.
A-- DRESS:
16834 NE 43rd Street
C. `Y: ZIP:
Bellevue 98006
TELEPHONE NUMBER AND EMAIL ADDRESS:
(206) 484-4321 tkassebaum@gmail.com - Travis
(4215) 818-8829 callidusland@comcast.net - Troy
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Cascade Greens
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
11427 SE 162nd Street
Renton WA 98055
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
008800-0260
EXISTING LAND USE(S): 1 SFR
PROPOSED LAND USE(S): Demo existing house. Create
a 4 lot short plat
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
EXISTING ZONING: R-6
PROPOSED ZONING (if applicable): n/a
SITE AREA (in square feet): 29,900
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED: 0
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
5322
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable) 7.62
NUMBER OF PROPOSED LOTS (if applicable)
4
NUMBER OF NEW DWELLING UNITS (if applicable):
4
- J_ers\tkassebaum\Desktop\Cascade Greens Short Plat Recording Items\A_ Application_Form_For_Land_Use_Permit_171026.doc Rev: 08/2015
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PROJECT INFORMAL
MBER OF EXISTING DWELLING UNITS (if applicable):
UARE FOOTAGE OF PROPOSED RESIDENTIAL
ILDINGS (if applicable): 12,000 - 4 @3000sf
UARE FOOTAGE OF EXISTING RESIDENTIAL
LDINGS TO REMAIN (if applicable): n/a
UARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
LDINGS (if applicable): n/a
DARE FOOTAGE OF EXISTING NON-RESIDENTIAL
LDINGS TO REMAIN (if applicable): n/a
T FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
licable): n/a
MBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
UJECT (if applicable): n/a
ION (continued
PROJECT VALUE:
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
❑ AQUIFIER PROTECTION AREA ONE
❑ AQUIFIER 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)
SITUATE IN THE NE QUARTER OF SECTION 29, TOWNSHIP 23, RANGE 5, IN THE CITY OF RENTON,
K'NG COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
print Name/s) Travis Kassebaum, declare under penalty of perjury under the laws of the State of Washington that I am (please check
oi 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.
�I
S ;natu of Owner/Representative Date Signature of Owner/Representative Date
ST ATE OF WASHINGTON )
SS
C ?UNTY OF KING )
I ; �rtify that I know or have satisfactory evidence that ��`ti % signed this instrument and
a, '-.nowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument.
//'Z • tP$*RA J. T,
e d STATE OF WASHINGTON
COMMISSION EXPIRES
OCTOBER 13, 2019
Notary Public ieand for theState of Washington
I>M2� -.�r
Notary (Print):
My appointment expires:
F4
/0-J_�3-209
t\tkassebaum\Desktop\Cascade Greens Short Plat Recording Items\A_Application_Form_For_Land_Use_Permit_171026.doc Rev: 08/2015