HomeMy WebLinkAboutA_LandUseMasterApplication_SESEA00218E_240117.pdfCITY OF RENTON I PERMIT SERVICES
' LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: Renton Heritage LLC PHONE: 425-451-8188
MAILING ADDRESS: 11747 NE 1ST ST STE 300, BELLEVUE, WA 98005 EMAIL:JimMaloney@cosmos-group.com
❑ [prefer to receive all correspondence via US mail.
APPLICANT (if other than owner)
FNAOE:Allen Koreis
NE: 360-250-2222
MAILING ADDRESS: 2606 67th Way NW, Olympia, WA 98502
❑ 1 prefer to receive all correspondence via US mail.
CONTACT PERSON
NAME: Same as above
PHONE:
MAILING ADDRESS:
❑ 1 prefer to receive all correspondence via US mail.
PROJECT INFORMATION
COMPANY (if applicable): Powder River Development
EMAIL: alien.koreis@powderriverdev.com
COMPANY (if applicable):
EMAIL:
PROJECT OR DEVELOPMENT NAME: Dish Wireless Site ID SESEA00218E
PROJECT/ADDRESS(ES) AND PARCEL NUMBERS: 207 Main Ave. S, Renton - 723150-1245
EXISTING LAND USE(S): Apartment Building PROPOSED LAND USE(S): WCF Collocation on Roof
fEXISTING COMPREHENSIVE PLAN MAP DESIGNATION: CD
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable):
EXISTING ZONING: CD
SITE AREA (in square feet): 500
` SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: N/A
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):
PROPOSED ZONING: No chanqe
PROJECT VALUE: $50,000
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable)-..
SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable):
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LAND USE PERMIT MASTER APPLICATION
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable):
I 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
❑ FLOOD HAZARD AREA
❑ GEOLOGIC HAZARD
❑ HABITAT CONSERVATION
❑ AQUIFER PROTECTION AREA TWO
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) See attached King
SITUATE IN THE
County Assessor Data
QUARTER OF SECTION TOWNSHIP N, RANGE
W.M IN THE CITY OF RENTON, KING COUNTY, WASHINGTON
SQ. FT.
SQ. FT.
AFFIDAVIT OF OWNERSHIP
3n ►n �s . P
I, (Print Name/s) declare finder 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
STATE OF WASHINGTON )
) SS
COUNTY OF KING
Signature of Owner/Representative Date
I certify that I know or have satisfactory evidence that _3�aYNC 5 lAJ�^'aL-i g signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purposdmentioned in the instrument.
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Dated
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Notary�Fu6ilic iry rid for the State of Washington
Notary (Print):
My appointment expires:
11 l L> `L-, l 2-7
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