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HomeMy WebLinkAboutA_Master Application_180425Print Farm Beset Form Save Form s DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT, � j Planning Division 5 1055 South Grady Way, 6th Floor I Renton, WA 980571425-430-7200 www.rentonwa.aOV �- LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) 0 NAME: Co n 5 tr10 ADDRESS: 3(01V6 J ''i"f I(&kv �'� p 0 CITY: ZIP: S I U TELEPHONE NUMBER: 4W-40 80 APPLICANT (if other than owner) NAME: t nl C Qom' WwLM COMPANY (if applicable): v n� ADDRESS:s- CITY: ���(, WU ZIP: TELEPHONE NUMBER: 2�2j—Cj `? — p I' ( I CONTACTPERSON NAME: j . u (�, W f--y►w1 n COMPANY (if applicable): S "qq� ADDRESS: CITY: ZIP: PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: PROJECT/ADDR S(S)/LOCATION MD'ZIP tOC -I23 900 5� 'R-tm n tk)A qj U S KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 1Z3©S 10-7 EXISTING LAND USE(S): Y► lju�La-Q PROPOSED LAND USE(S): EXISTING COMPREHENSIVE PLAN MAP DESIGNATION. F f - 1P I�o�N� N - A PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) t,) /A `/A EXISTING ZONING: f M - NlEDIvM i V3DVS-1 lAA,, PROPOSED ZONING (if applicable): N 1 SITE AR(�square�feet):5, D! SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) IC2/J NUM=OFPROPOSEDOTS (if applicable) TELEPHONE NUMBER AND EMAIL ADDRESS: (I NUMBER OF NEW DWELLING UNITS (if applicable): Je nn � F� w-Qsld�►ten . � m 1 H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017 PROJECT INFORMATION (continued NUMBER OF EXISTING DWELLING UNITS (if applicable): A)//9 SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): ;J SQUARE FOOTAGE OF EXISTING RESIDENTI L BUILDINGS TO REMAIN (if applicable): N /1 SQUARE FOOTAGE OF PROPOSED N N- ESIDENTIAL BUILDINGS (if applicable): /V � Z4 SQUARE FOOTAGE OF EXISTING NON -RES DENTIAL BUILDINGS TO REMAIN (if applicable): r 6 0 NET FLOOR AREA ON NON-RESIDENTIAL BUIILLDINGS (if applicable): tJ I A NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): (P D / p 0 PROJECT VALUE: IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable): N �0 AQUIFER PROTECTION AREA ONE ❑ AIFER PROTECTION AREA TWO 13FLOOD RD AREA sq. ft. ❑ GEOLOGIC HAZARP _ sq. ft. ❑ HABITAT CONSERVATION, sq. ft. ❑ SHORELINE STREAMS & LAKLS)ksq. ft. ❑ WETLANDS / \_ sq. ft. LEGAL DESCRIPTION OF PROPERTY Attach leaal descriotion on separate sheet with the followinq information incl SITUATE IN THE QUARTER OF SECTION , TOWNSHIP Z 3 , RANGE , IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP I, (Print Name/s) TAO 1145Q� Q� ���� J� �� ` 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 [K the authorized representative to act for a corporation (please attach proof of authorization) and that the foregoing statements and answers herein c tained and the information herewith are in all respects true and correct to the best of my knowledge and belief. G_ C Ana � Signature of Owne Representative Date Signature of Owner/Representative Date STATE OF WASHINGTON ) SS COUNTY OF KING ) I certify that I know or have satisfactory evidence that \� ��` 1 signed this instrument and acknowledge it to be his/her/their free and voluntary act for the us and purpose mentioned in the instrument. Dated �N. Notary Public in and for the State of Washington `\\mow Notary (Print): My appointment expires: ►q H:\CED\Data\Forms-Templates\Self-Help Han douts\Planning\M aster Application.doc Rev: 10/2017 cC40NSE340 Counseling and Referral Service BOARD RESOLUTION At the meeting of the Board of Directors of Consejo Counseling and Referral Service on May 22, 2017, the following resolution was proposed and approved by the Board: Resolved: WHEREAS the mission of the Consejo Counseling and Referral Service is to provide behavioral health services, domestic violence services, sexual assault services and housing services to low income individuals and empower them to became active and productive members of society. WHEREAS Consejo's Board of Directors reached an agreement that the current headquarters building located at 3808 South Angeline, Seattle, WA. 98118 does no longer meet the organizational needs and/or new requirements of integrated care. WHEREAS Consejo's Board of Directors reached an agreement to purchase the RCRC Medical Building located at 723 SW 10th Street, Renton, WA for the asking price of $3,876,000.00 ($200/square foot). WHEREAS Consejo's Board of Directors authorized Mario Paredes, Consejo's Executive Director, to pursue a purchase and sale agreement and acquire all necessary financing to purchase the RCRC Medical Building located at 723 SW 10th Street, Renton, WA. WHEREAS Consejo's Board of Directors Authorized Mario Paredes, Consejo's Executive Director, to relocate all administrative and clinical services at the new facility in a 24 -36 -month plan. SIGNED AND DATED: PRINTED NAME: PRINTED NAME: AFFILIATION.- AFFILIATION: Ct6um­ Z_ " K witm 9-0-< fin' �k I,