HomeMy WebLinkAboutA_Notorized Master Application 120 Hardie AveCITY OF RENTON I PERMIT SERVICES
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
~NAME: Karen La/Yi Jun 3 LLC PHONE: 2063515791
MAILING ADDRESS: 4004 NE 4th St #107-514, Renton WA
[J refer to receive all correspondence via US mail.
EMAIL: drkarenla@gmail.com
APPLICANT (if other than owner)
NAME: Same as owner COMPANY (if applicable):
PHONE: EMAIL:
MAILING ADDRESS: n I prefer to receive all correspondence via US mail.
CONTACT PERSON
NAME: Karen La COMPANY (if applicable):
PHONE: 2063515791 EMAIL: drkarenla@gmail.com
MAILING ADDRESS: 4004 NE 4th St #107-514, Renton WA 98056 n I prefer to receive all correspondence via US mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME: 120 Hardie Ave Backyard Tree Removal
PROJECT/ADDRESS(ES) AND PARCEL NUMBERS: 120 Hardie Ave SW, Renton I 182305-9009
EXISTING LAND USE(S): Remove the tree per arborist report PROPOSED LAND USE{S):
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable):
EXISTING ZONING: PROPOSED ZONING:
SITE AREA (in square feet):
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:
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable):
rentonwa.gov/permitservices I planningcustomerservice@rentonwa.gov I 425-430-7294 01/27/2025 I Page 1 of 2
LAND USE PERMIT MASTER APPLICATION
SQ.UAREFQ ~ OTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable):
SQ.UARE FOO
t---_ TAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable):
~ET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable):
~ 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 FOOTAGE (if applicable): -AQUIFER PROTECTION AREA ONE § AQUIFER PROTECTION AREA TWO FLOOD HAZARD AREA SQ. FT. SHORELINE STREAMS & LAKES SQ. FT. -EOLOGIC 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 ________ QUARTER OF SECTION ___ __, OWNSHIP ___ W.M IN N, RANGE __ _,
THE CITY OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Kt:w::e/\ \.\~ l£, , 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 myP:,k}'9~edge and belief.
~ .7u~ C 2. • 'h,£-f -----------------------
Signature of Owner/Representative Date Signature of Owner/Representative Date
STATE OF WASHINGTON )
ss
COUNTY OF KING
fy h I k h Sati.sfactory evidence that v<...0f&-J LA signed this instrument and I certi t at now or ave . . . acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument.
Dated
CHRISTINE BOROUGH
Notary Public
State of Washln1ton
Commission# 2302989-4
My Comm. Expires Aug 19, 2027
Notary Public in and for the State of Washington
Notary (Print):
My appointment expires: ____ .....I.?i).J/µ1~9L\~Z. ... 1l------------
rentonwa.gov/permltservlces I plann1ngcustomerservlce@rentonwa.gov I 425-430-7294 01/27/2025 I Page 2 of 2