HomeMy WebLinkAboutA_Rolling Hills Ave SE - Land Use App - signedCITY OF RENTON I PERMIT SERVICES
LAND USE PERMIT MASTER APPLICATION
NAME:City of Renton PHONE:(425)430-7293
MAILING ADDRESS:1055 South Grady Way,Renton WA,98057 EMAlLjmcd0nald@rentonWa.gOV
refer to receive all correspondence via US mail.
APPLICANT (if other than owner)
NAME:Jared McDonald COMPANY (if applicable):CIty of Renton
PHONE:(425)430 -7293 EMAIL:jmcd0flald@rentoflWa.gov
MAILING ADDRESS:1055 South Grady Way,Renton WA,98057
JIprefer to receive all correspondence via US mail.
CONTACT PERSON
NAME:Jared McDonald COMPANY (if applicable):City of Renton
PHONE:(425)430-7293 EMAIL:jmcdonald@tentoflwa.gov
MAILING ADDRESS:1055 South Grady Way,Renton WA,98057
I prefer to receive all correspondence via US mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:Rolling Hills Ave SE Pipe Rehabilitation
PROJECT/ADDRESS(ES)AND PARCEL NUMBERS:1901-1913 RoIling Hills Ave SE,Renton,WA 98055 (City of Renton-ROW &Parcel 7399200870)
EXISTING LAND USE(S):Residential PROPOSED LAND USE(S):Residential (No Change)
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:Residential Medium Density
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable):N/A
EXISTING ZONING:R8 PROPOSED ZONING:R8 (No Change)
SITE AREA (in square feet):1,500sf for staging of pipe lining vehicles
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED:N/A
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable):N/A
NUMBER OF PROPOSED LOTS (if applicable):N/A
NUMBER OF NEW DWELLING UNITS (if applicable):N/A
NUMBER OF EXISTING DWELLING UNITS (if applicable):N/A PROJECT VALUE:N/A
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable):N/A
SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable):N/A
PROPERTY OWNER(S)
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LAND USE PERMIT MASTER APPLICATION
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)SITUATE
SE QUARTER OF SECTION 20 ,OWNSHIP__23 W.M IN N,RANGE 05 E
THE CITY OF RENTON,KING COUNTY,WASHINGTON
AFFIDAVIT OF OWNERSHIP
I,(Print Name/s)Jared McDonad ,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 ate in all respects true and correct to the best
of my knowledge an bell f.
Signature of Owner/Representative Date
STATE OF WASHINGTON)
COUNTY OF KING
Notarj Pubhcin and for the of Washington.
NotaryPrint):
My appointment expires:3
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable):N/A
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable):N/A
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable):N/A
NUMBER OF EMPLOYEES TO BE EMPLOYED BYTHE NEW PROJECT (if applicable):N/A
IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA,PLEASE INCLUDE SQUARE FOOTAGE (if applicable):
AQUIFER PROTECTION AREAONE AQUIFER PROTECTION AREATWO
FLOOD HAZARD AREA
________________
SQ.FT.SHORELINE STREAMS &LAKES N/A(PipedSystem-100LF)50 FT.
EOLOGIC HAZARD
______________
SQ.FT.WETLANDS
______________
SQ.FT.
HABITATCONSERVATION
______________
SQ.FT.
IN THE
55
Signature of Owner/Representative Date
Icertify 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.
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