HomeMy WebLinkAboutMaster Application_SignedCITY OF RENTON I PERMIT CENTER
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: City of Renton
MAILING ADDRESS: 1055 S. Grady Way, Renton 98057
❑ 1 prefer to receive all correspondence via US mail.
APPLICANT (if other than owner)
NAME:
PHONE:
MAILING ADDRESS:
❑ 1 prefer to receive all correspondence via US mail.
CONTACT PERSON
NAME: Betsy Severtsen
PHONE: 425-430-6611
MAILING ADDRESS: 1055 S. Grady Way, Renton 98057
❑ [prefer to receive all correspondence via US mail.
PROJECT INFORMATION
PHONE:425-430-6611
EMAIL: bsevertsen@rentonwa.gov
COMPANY (if applicable).
EMAIL:
COMPANY (if applicable):
EMAIL:bsevertsen@rentonwa.gov
PROJECT OR DEVELOPMENT NAME: Springbrook Trail Boardwalk Replacement
PROJECT/ADDRESS(ES) AND PARCEL NUMBERS: Parcel number: 1253810090
EXISTING LAND USE(S): RC - Resource Conservation PROPOSED LAND USE(S): RC - Resource Conservation
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: Employment Area
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable):
EXISTING ZONING: RC - Resource Conservation
SITE AREA (in square feet): 800 sf
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: N/A
PROPOSED ZONING: RC - Resource Conservation
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: repair estimate: $253,640
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): N/A
SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A
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LAND USE PERMIT MASTER APPLICATION
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 BY THE 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 AREA ONE ❑ AQUIFER PROTECTION AREA TWO
❑ FLOOD HAZARD AREA SQ. FT. ❑ SHORELINE STREAMS & LAKES
❑ GEOLOGIC HAZARD
❑ HABITAT CONSERVATION
LEGAL DESCRIPTION OF PROPERTY
SQ. FT. i7 WETLANDS
SQ. FT.
SQ. FT.
800 SQ. FT.
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE NW QUARTER OF SECTION 30 , TOWNSHIP 23 N, RANGE 5
W.M IN THE CITY OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Be1,1... len' 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 of/,ihe 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.
Signature of Owner/Representative Date Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING
I certify that I know or have satisfactory evidence that 6_42_11t4 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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My appointment expires: 9 d-3_0-
to of Washington
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