HomeMy WebLinkAboutBiniam_Notary_2LAND USE PERMIT MASTER APPLICATION
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): tilA
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable}: 1J IA
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if applicable}:
NUMBER OF EMPLOYEES TO BE EMPLOYED BY 7HE NEW PR0IECT (if applicable}:
IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA,
PLEASE INCLUDE SQUARE FOOTAGE (if applicable}: �j
❑ AQUIFER PROTECTION AREA ONE ❑ AQUIFER PROTECTION AREA TWO
❑ FLOOD HAZARD AREA
SQ. FT. ❑ SHORELINE STREAMS &LAKES SQ• �•
❑ GEOLOGIC HAZARD
SQ. FT. ❑ WETLANDS SQ. FT.
❑ HABITAT CONSERVATION SQ. FT. _____
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description an separate sheet with the fallowing information included)
SITUATE IN THE C:t! �.t'l � ��tic4UARTER OF SECTION ,W.�i.l TOWNSHIP �-� N, RANGE '�
W.M IN THE CITY OF RENTON, KING COUNTY, WASHINGTON
AFFIDAV[T OF OWNERSHIP
I N' 1�i`�l ��N � A � r2�h �,
I, (Print Name/s) r� ,declare under penalty of perjury under the laws of the State of Washington that I am {please
cheek 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
STATE OF WASHINGTON )
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Date
SS
COUNTY OF KING ) � � �� � � /�� ���be l 1 � �` e
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I certify that I know or have satisfactory evidence that l� signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument.
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a e ���I��� Notary Public in and for the State of Washington
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rentonwa, o� .>���►►i���'�1 planningcustomerservice@rentonwa.gav � 425-430-7294
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10/24/2023 � Page 2 of 2