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HomeMy WebLinkAboutA_Neighbor_Olsen_Application_v1.pdfPrint Form Reset Form Save Form DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT Planning Division 1055 South Grady Way, 6th Floor I Renton, WA 98057 1 425-430-7200 www.rentonwa.gov LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) NAME: Christine Olsen ADDRESS:4006 Lincoln Ave NE CITY: Renton STATE 4WA 98056 PHONE NUMBER: (425) 736-1549 EMAIL ADDRESS*: adaminalaron@gmail.com 0 I prefer to receive all correspondence via US Mail. APPLICANT (if other than owner) NAME: COMPANY (if applicable) - 'Glacial Ventures 11 LLC ADDRESS:18300 Redmond Way, Suite 140 CITY. Redmond STATE: WA ZIP: �98052 PHONE NUMBER: EMAIL ADDRESS*:admin@bluefern.com ❑ I prefer to receive all correspondence via US Mali. CONTACT PERSON NAME: Holli Heavrin COMPANY (if applicable): Core Design, Inc. ADDRESS:12100 NE 195th Street, Suite 300 CITY: Bothell STATE: WA ZIP: 98011 PHONE NUMBER (425) 885-7877 EMAIL ADDRESS'HHH@coredesigninc.com ❑ I prefer to receive all correspondence via US Mail. PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: Canopy Boundary Line Adjustment PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: 2020 NE 40th Street and 4006 Lincoln Avenue NE, Renton, WA 98056 KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 334570-0017 and 334570-0019 EXISTING LAND USE(S): PROPOSED LAND USE(S): EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) EXISTING ZONING: R-8 PROPOSED ZONING (if applicable): N/A SITE AREA (in square feet): SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: 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: *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. PROJECT INFORMATION (CONTINUED) 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): 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. ❑ SHORELINE STREAMS & LAKES sq. ft. ❑ WETLANDS sq. ft. LEGAL DESCRIPTION OF PROPERTY Attach legal description on separate sheet with the following information included SITUATE IN THE NE QUARTER OF SECTION 32 TOWNSHIP 24 N, RANGE 5 _,W.M. IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP I, (Print Name/s) d'hou ,,ln 9 n6ieh, 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. �/A/%, ® 31 111 Z Signature of O r/ epresentative Date STATE OF WASHINGTON ) ) SS COUNTY OF KING 1 Signature of Owner/Representative Date I certify that I know or have satisfactory evidence that l [ G Ob �Ci signed this instrument and acknowledge it to be his/her/their free and voluntary acTTor the uses and purpose mentioned in the instrument. '5f 1-7 -- Dated Wendy Beach Notary Public State of Washington Commission Number 20112379 My Commission Expires June 30, 2024 Notary Public in and for the State of Washington Notary (Print): My appointment expires: h yo 3l�. p�-V