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Home My WebLink AboutA_Master_Land_Use_Application_Form_190221_v1.pdfPrintForm Reset Form Save Form DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT r Planning Division 1055 South Grady Way, 6th Floor I Renton, WA 980571425-430-7200 www.rentonwa.gov LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) NAME: Jaswant Dhaliwal ADDRESS: 2215 Morris Ave. S CITY: Renton ZIP: 98055 TELEPHONE NUMBER: 206-915-2778 APPLICANT (if other than owner) NAME: Jaswant Dhaliwal COMPANY (if applicable): ADDRESS: 2215 Morris Ave. S CITY: Renton ZIP: 98055 TELEPHONE NUMBER: 206-915-2778 CONTACT PERSON NAME: Lou Larsen COMPANY (if applicable): Pacific Engineering Design, LLC ADDRESS: PO Box 24060 CITY:Federal Way ZIP: 98093 TELEPHONE NUMBER AND EMAIL ADDRESS: 206-431-7970 llarsen@paceng.com PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: Madueno Property PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: 19805 108th Ave. SE Renton, WA 98055 KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 0522059078 EXISTING LAND USE(S): Single Family Residential PROPOSED LAND USE(S): Single Family Residential EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: Residential Low Density PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) Same EXISTING ZONING: R-4 PROPOSED ZONING (if applicable): Same SITE AREA (in square feet): 97,174 Sq Ft SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: 25,373 Sq Ft SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: N/A PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) 3.66 DU/AC NUMBER OF PROPOSED LOTS (if applicable) 6 NUMBER OF NEW DWELLING UNITS (if applicable): 6 H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017 PROJECT INFORMATION (continu NUMBER OF EXISTING DWELLING UNITS (if applicable): 1 SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A 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 PROJECT VALUE: $3, 600, 000 IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable): C C C AQUIFER PROTECTION AREA ONE AQUIFER PROTECTION AREA TWO ❑ GEOLOGIC HAZARD ❑ HABITAT CONSERVATION ❑ SHORELINE STREAMS &LAKES ❑ WETLANDS (Attach legal description .included) SITUATE IN THE NW QUARTER OF •N 5, TOWNSHIp OF •COUNTY,• AFFID"IT OF OWNERSHIP ( ) /�- `S W/4- �tJ'T S � '�-�/� L—1 WA �. declare under enal of e u under the laws of the State of I, Print Name/s p ty p rl ry Washington that I am (please check one) F71 the current owner of the property involved in this application or Q 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 my knowledge and belief. c nature of Owner/Representative Date STATE OF WASHINGTON Signature of Owner/Representative I SS COUNTY OF KING ) c I certify that I know or have satisfactory evidence that 3C,S% 3 °`n� S 0 `\A\4W6' \ signed this instrument and acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument. Dated STATE OF WASHINGTON COMMISSION EXPIRE APRIL 29, 2022 Notary Public in and�r the State of Washington Notary (Print): My appointment expires: 2 H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017 NUMBER OF EXISTING DWELLING UNITS (if applicable): 1 SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A 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)IF : N / A NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): N/A PROJECT VALUE: $3, 600, 000 IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable): ❑ AQUIFER PROTECTION AREA ONE ❑ GEOLOGIC HAZARD ❑ HABITAT CONSERVATION ❑ SHORELINE STREAMS &LAKES ❑ WETLANDS (Attach legal description on separate sheet with the following information included) SITUATE IN THE NW QUARTER OF SECTION 5 TOWNSHIp 2 2 RANGE 5 E IN THE CITY OF RENTON, KING COUNTY,WASHINGTON OF I, (Print Name/s) ,declare under penalty of perjury under the laws of the State of Washington that I am (please check one) E4the current owner of the property involved in this application or Q 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 my knowledge and belief. Signature of Ownerl�epresentative STATE OF WASHINGTON ) SS COUNTY OF KING ) Date ® Signature of Owner/Representative I know o ha a satisfacto evidence that �� I certify that ry acknowledge it to b his er/their free and voluntary act for the uses and purpose r si ned this instrument and 9 in the instrument. My appointment expires: 2 H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017 NUMBER OF EXISTING DWELLING UNITS (if applicable): 1 SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable): SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A 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 PROJECT VALUE: $3, 600, 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 ❑ GEOLOGIC HAZARD ❑ HABITAT CONSERVATION ❑ SHORELINE STREAMS &LAKES ❑ WETLANDS (Attach legal description on separate sheet with the following inf.included) SITUATEOF • • OF •COUNTY,• AFFID"IT OWNERSHIP I, (Print Name/s)' � � 17 c5 \ Z....�-� ✓" ,declare under penalty of perjury under the laws of the State of Washington that 1 am (please check one) the current owner of the property involved in this application or Q 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 my knowledge and belief. �� S � • o/ c2 �1 0�l 5 Signature of Owner/Representative Date Signature STATE OF WASHINGTON ) SS COUNTY OF KING ) of Owner/Representative Date I certify that I know o h ve satisfactory evidence that C � �� ®� signed this instrument and acknowledge it to bellis er/their free and voluntary act for the uses and purpose mentioned in the instrument. MARIA VICTORIA FEERO Iy4TARY PUBLIC STATE OF WASHINGTON COMMISSION EXPIRES APRIL 29, 2022 Notary (Print): H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017