HomeMy WebLinkAboutA_Master_Application_180301_v1DEPARTMENT OF COMMUNITY CITY OF
AND ECONOMIC DEVELOPMENT Denton`'
�s
Planning Division
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: A v CSG' l[ INC
ADDRESS: �} t l 7
CITY: r (�`-� ` 1 ZIP:
TELEPHONE NUMBER: �O���j ' l /
APPLICANT (if other than owner)
NAME: • C . Ko rf,:*5A
COMPANY (if applicable) -
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ADDRESS: G� 110
CITY:`, -tel A 1,19
ZIP:
TELEPHONE NUMBER:
CONTACT PERSON
NAME: 'y& -t/0 mg
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COMPANY (if applicable):
.- 1 D �`DC
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ADDRESS: 6e6D g (I ov-
CITY: )/ r� � Uk-ti/ZIP: �f 2
TELEPHONE NUMBER AND EMAIL ADDRESS:` J
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PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
V q /v
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
334 �)ctc-� , 252
EXISTING LAND USE(S):�
PROPOSED LAND USE(S):
2)Le��-� -�E)r-
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
r(D
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable) , J
EXISTING ZONING: /�J
PROPOSED ZONING (if applicable): ���
g �J� (2-
SITE AREA (in square feet): 6- p
/ I
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable) z
NUMBER OF PROPOSED LOTS (if applicable)
IU
NUMBER OF NEW DWELLING UNITS (if applicable):
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015
PROJECT INFORMA7
NUMBER OF EXISTING DWELLING UNITS (if applicable):
C) A)C- -
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable): �/
SQUARE FOOTAGE OF EXISTING RESIDENTIAk
BUILDINGS TO REMAIN (if applicable): 11VII
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable): A / /1_
SQUARE FOOTAGE OF EXISTING/'ANON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): ACJ/A,
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable): )
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable):
IVN continued
PROJECT VALUE:
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
❑ AQUIFIER PROTECTION AREA ONE
AQUIFIER 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 followinU information included
SITUATE IN THE `DW 114 QUARTER OF SECTION , TOWNSHIP RANGE J E, 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) t5,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/Repr entative Date Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that "�ti k h A 1 UL signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument.
2,24- 2,017T
Dated Qa F //// Notary Public in and for
� `SSION�f ihry/dip
State of Washington
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pTA A `
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� a R � J�"\dI,U'er
Nttary (Print):
// F "iment expires:
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H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2015