HomeMy WebLinkAboutA_Land_Use_Master_Application_180907_v1.pdfLAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: Gerald Cornwall / Stacey Johnson
ADDRESS: 1038 N 41 st PI
CITY: Renton ZIP: 98056
TELEPHONE NUMBER: (206) 856-3325
APPLICANT (if other than owner)
NAME:
COMPANY (if applicable):
ADDRESS:
CITY: ZIP:
TELEPHONE NUMBER:
CONTACT PERSON
NAME: Evan Wehr
COMPANY (if applicable): Ecco Design Inc.
ADDRESS:203 N. 36th St, Suite 201
CITY: Seattle ZIP: 98103
TELEPHONE NUMBER AND EMAIL ADDRESS:
(206) 706-3937
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Cornwall Boat Lift
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
4151 Williams Ave. N
Renton, WA 96056
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
0518500350
3224059066
EXISTING LAND USE(S):
Residential
PROPOSED LAND USE(S):
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
COR
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
EXISTING ZONING:
R-10
PROPOSED ZONING (if applicable):
SITE AREA (in square feet):
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
750
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
NUMBER OF PROPOSED LOTS (if applicable)
NUMBER OF NEW DWELLING UNITS (if applicable):
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017
PROJECT INFORMA
NUMBER OF EXISTING DWELLING UNITS (if applicable):
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable):
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable):
TION continued
PROJECT VALUE:
$12,000
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.
❑ GEOLOGIC HAZARD sq. ft.
❑ HABITAT CONSERVATION sq. ft.
O SHORELINE STREAMS & LAKES 12,691 sq. ft.
❑ WETLANDS sq. ft.
LEGAL DESCRIPTION OF PROPERTY
Attach legal description on separate sheet with the following information included
SITUATE IN THE NW QUARTER OF SECTION 32 , TOWNSHIP 24,RANGE 5 IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
/�' f !� /�Ci.•Jdhrtsdn
I, (Print Name/s) �ierCu GL V. &L UJQL� I * Gl _ / ,declare under penalty of perjury under the laws of the State of
Washington that I am (please check one) LAJ the current owner of the property involved in this application or 0 the authorized
representative to act for a corporation (please attach proof of authorization) and that the foregoing statements and answers herein
contained and the infgrmation here o"re in all respects true and correct to)a best of my knowledge and belief.
9
Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that I ',era I T Cunwa ff ti o' S(-accu J-;hn�rsigned this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mention d in the instrument.
5 Z3 al l
Date
CHRISTOPHER J CONN
NOTARY PUBLIC
STATE OF WASHINGTON
MVC4ffC4W ERphs November 11, 2021
in and for the State of Washington
Notary
My appointment expires: I I / / t// zt L
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017
LEGAL DESCRIPTION OF PROPERTY
Attach legal description on separate sheet with the following information included
SITUATE IN THE NW QUARTER OF SECTION 32 , TOWNSHIP 24,RANGE 5 IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
/�' f !� /�Ci.•Jdhrtsdn
I, (Print Name/s) �ierCu GL V. &L UJQL� I * Gl _ / ,declare under penalty of perjury under the laws of the State of
Washington that I am (please check one) LAJ the current owner of the property involved in this application or 0 the authorized
representative to act for a corporation (please attach proof of authorization) and that the foregoing statements and answers herein
contained and the infgrmation here o"re in all respects true and correct to)a best of my knowledge and belief.
9
Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that I ',era I T Cunwa ff ti o' S(-accu J-;hn�rsigned this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mention d in the instrument.
5 Z3 al l
Date
CHRISTOPHER J CONN
NOTARY PUBLIC
STATE OF WASHINGTON
MVC4ffC4W ERphs November 11, 2021
in and for the State of Washington
Notary
My appointment expires: I I / / t// zt L
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017