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HomeMy WebLinkAboutA_LandUseMasterApplication_220629_v1DEPARTMENT 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: