HomeMy WebLinkAboutA_Master Application_Broodstock_210115_v1.pdfDEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Planning Division
1055 South Grady Way, 6th Floor | Renton, WA 98057 | 425-430-7200
www.rentonwa.gov
*By completing the email address field the owner/applicant/contact person is opting to receive all formal notifications
and project documents in digital format via email unless otherwise requested.
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S) PROJECT INFORMATION
NAME: PROJECT OR DEVELOPMENT NAME:
ADDRESS: PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
CITY: STATE: ZIP:
PHONE NUMBER: KING COUNTY ASSESSOR’S ACCOUNT NUMBER(S):
EMAIL ADDRESS*:
I prefer to receive all correspondence via US Mail.
APPLICANT (if other than owner)EXISTING LAND USE(S):
NAME: PROPOSED LAND USE(S):
COMPANY (if applicable): EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
ADDRESS: PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable)
CITY: STATE: ZIP: EXISTING ZONING:
PHONE NUMBER: PROPOSED ZONING (if applicable):
EMAIL ADDRESS*:
I prefer to receive all correspondence via US Mail.
SITE AREA (in square feet):
CONTACT PERSON SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
NAME: SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
COMPANY (if applicable): PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
ADDRESS: NUMBER OF PROPOSED LOTS (if applicable)
CITY: STATE: ZIP: NUMBER OF NEW DWELLING UNITS (if applicable):
PHONE NUMBER NUMBER OF EXISTING DWELLING UNITS (if applicable):
EMAIL ADDRESS*:
I prefer to receive all correspondence via US Mail.
PROJECT VALUE:
PROJECT INFORMATION (CONTINUED)
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable):
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
AQUIFER PROTECTION AREA ONE
AQUIFER PROTECTION AREA TWO
FLOOD HAZARD AREA sq. ft.
GEOLOGIC HAZARD sq. ft.
HABITAT CONSERVATION sq. ft.
SHORELINE STREAMS & LAKES sq. ft.
WETLANDS sq. ft.
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):
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE ___________ QUARTER OF SECTION ______, TOWNSHIP ______ N, RANGE ______ ___,W.M. IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) , 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 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 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 Notary Public in and for the State of Washington
Notary (Print):
My appointment expires:
1. Legal description for the property south of the Cedar River (Parcel ID 1723059014):
POR OF GOV LOT 5 IN SW 1/4 LY NLY OF PACIFIC COAST RR B N R R CO TGW
POR OF SW 1/4 LY ELY OF STATE HWY SR 405 & NLY OF PACIFIC COAST RR
B N RR CO & SLY OF CEDAR RIVER LESS POR LY ELY OF R/W OF NEW
CASTLE BRANCH & NELY OF R/W OF BLACK DIAMOND BRANCH C & PS RY
& CEDAR RIVER BEING A TRIANGULAR PIECE
2. Legal description for the property north of the Cedar River (Parcel ID 1723059013): POR
OF GL 4 IN W 1/2 & SW 1/4 OF NE 1/4 & SE 1/4 LY BTWN COLUMBIA & PUGET
SOUND R/W & RENTON-MAPLE VALLEY RD & NLY OF LN BEG ON WLY
MARGIN OF SAID ROAD 80 FT NWLY FROM S LINE OF NE 1/4 TH S 47-52-00 W
273.22 FT TH S 88-26-00 W 251.95 FT TH S 39-24-35 W 73.20 FT TH N 79-04-40 W
176.04 FT TH S 27-52-20 W LESS ST HWY LESS BEG INTSN SELY LINE & SLY
MGN OF MAPLE VALLEY RD TH NWLY ALG SD MGN 60 FT TO POB TH
CONTG NWLY 100 FT TH SWLY PLW SD SELY LN 225 FT TH SELY PLW SD
MGN 100 FT TH NELY 225 FT TO POB LESS POR LY NWLY OF A LN BAAP
OPPOSITE HWY ENGR STA HES LN 259+91.82 P C ON THE LN LINE SURVEY
OF SR 405 RENTON S CURVES & 80 FT SELY THEREFROM TH NELY PLW SD
LN SURVEY TAP OPPOSITE HES LN 267+60 TH NELY TAP OPPOSITE HES LN
271+00 ON SD LINE SURVEY & 114 FT SELY THEREFROM TH NELY PLW SD
LINE SURVEY TAP OPPOSITE HES LN 273+00 POT THEREON & END OF LINE
FOR STATE HWY LESS POR FOR RD PER DEED #20050418000001