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HomeMy WebLinkAboutA_Master_Application_2501150CITY OF RENTON I PERMIT SERVICES
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: TA Benson Petro LLC PHONE: TA Benson Petro LLC
MAILING ADDRESS: 2600 Dallas Parkway, Suite 370, Frisco, TX 35034 EMAIL: schiquet@teklndevelopment.Com
prefer to receive all correspondence via US mail.
APPLICANT (if other than owner)
NAME: COMPANY (if applicable):
PHONE: EMAIL: schiquet@tekindevelopment.com
MAILING ADDRESS: 2600 Dallas Parkway, Suite 370, Frisco, TX 35034
I prefer to receive all correspondence via US mail.
CONTACT PERSON
NAME: Sean Chlquet COMPANY (if applicable):
PHONE: 9165216892 EMAIL: schiquet@tekindevelopment.com
MAILING ADDRESS: 2600 Dallas Parkway, Suite 370, Frisco, TX 35034
I prefer to receive all correspondence via US mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME: PR22-000345 TA Benson Petro
PROJECT/ADDRESS(ES) AND PARCEL NUMBERS: 17426 Benson Drive SOuth;10828/1810 SE Petrovitsky Road
EXISTING LAND USE(S):COMmerclal PROPOSED LAND USE(S): Commercial
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: Commercial Mixed Use
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable):
EXISTING ZONING: PROPOSED ZONING:
SITE AREA (in square feet): 83,703
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED:
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable):
NUMBER OF PROPOSED LOTS (if applicable):
NUMBER OF NEW DWELLING UNITS (if applicable):
NUMBER OF EXISTING DWELLING UNITS (if applicable): PROJECT VALUE: 3,000,000
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable):
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LAND USE PERMIT MASTER APPLICATION
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): 4 � 088
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable):0
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable): 4,088
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable):
IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGF (if applicable):
❑ AQUIFER PROTECTION AREA ONE ❑ AQUIFER PROTECTION AREA TWO
❑ FLOOD HAZARD AREA SQ. FT. ❑ SHORELINE STREAMS & LAKES SQ. FT.
❑ GEOLOGIC HAZARD SQ. FT. ❑ WETLANDS SQ. FT.
❑ HABITAT CONSERVATION SQ. FT.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE SW 1/4 OF THE SE1/4 QUARTER OF SECTION 29 TOWNSHIP 23 N, RANGE 5 E.
W.M 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 know d e and be
Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING
Signature of Owner/Representative Date
y satisfactory evidence �e.�c /\ signed this instrument and
I certify that I know or have satisfactor evidence that
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument.
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Notary Public in and for the State of Washington
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Notary (Print):
My appointment expires: —I-
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