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AFFIDAVIT OF INSTALLATION OF
PUBLIC INFORMATION SIGN
Planning Division
1055 South Grady Way, Renton, WA 98057
Phone: 425-430-7200 | www.rentonwa.gov
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
1. I, ____________________________________, certify under penalty of perjury under the laws of the
State of Washington that the foregoing is true and correct, being first duly sworn on oath, deposes and
says:
2. On the ________ day of _________________________, 20_______, I installed ________
public information sign(s) on the property located at _____________________________ for the
following project:
Project Name
Owner Name
3. I have attached a copy of the neighborhood detail map marked with an “X” to indicate the location of
the installed sign.
4. This/these public information sign(s) was/were constructed and installed in locations in conformance
with the requirements of Chapter 8 Title 4 of Renton Municipal Code and the City’s “Public Information
Signs Installation” handout package.
Installer Signature
SUBSCRIBED AND SWORN to before me this _____ day of _______________, 20_____.
NOTARY PUBLIC in and for the State of Washington,
residing at .
My commission expires on
4,514 376
KLSSIP - PUBLIC NOTICE SIGN INSTALL
Legend
0 128
Notes
256
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