HomeMy WebLinkAboutA_Land_Use_Permit_Master_Application_240904_v1CITY OF RENTON I PERMIT SERVICES
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: Yaling Jin PHONE: 425-208-5113 -----. ---------------------------------------
MAILING ADDRESS: 14264 SE 83rd Street, Renton, WA 98059
□ prefer to receive all correspondence via US mail.
APPLICANT (if other than owner)
EMAIL: yjin897@gmail.com
-------··-----·-·-·-·-··•------···--------------------------·---·-
NAME: COMPANY (if applicable):
PHONE: EMAIL:
MAILING ADDRESS:
0 1 prefe~ to recei~;;I~ cor;e~~ondence via US mail.
CONTACT PERSON
NAME: Yaling Jin COMPANY (if applicable):
PHONE: 425-208-5113 EMAIL: yjin897@gmail.com
MAILING ADDRESS:
D I prefer to receive all correspondence via US mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME: Jin residence driveway replacement
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PROJECT/ADDRESS(ES) AND PARCEL NUMBERS: 4304 SE 3rd Street, Renton, WA 98059, Parcel# 3211000 130
' EXISTING LAND USE(S): single family home and city's right-of-way PROPOSED LAND USE(S):s_tngle family home and city
na ht-of-wav
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable):
EXISTING ZONING: R6 PROPOSED ZONING: R6
SITE AREA (in square feet): 750
, 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: $15000 ___ )
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): 1020
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LAND USE PERMIT MASTER APPLICATION
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable):
1 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 D AQUIFER PROTECTION AREA TWO
______ SQ. FT. □ SHORELINE STREAMS & LAKES
______ SQ.FT. □ WETLANDS
□ FLOOD HAZARD AREA
1 D GEOLOGIC HAZARD
□ HABITAT CONSERVATION ______ SQ. FT.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
______ SQ. FT.
______ SQ.FT.
SITUATE IN THE SW QUARTER OF SECTION 15 TOWNSHIP 23 N, RANGE _5 _ ___,
W.M IN THE CITY OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Yaling Jin 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. -Afd¥ ~
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 '( 4\ '"j 3\ n 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
N"tary Public
State of Wasldqton
JUmNDANAO
LICENSE# 23018716
MY COMMISSION EXPIRES
JUNE 13, 2027
Notary il,;;;o, the State of Washington
Notary (Print):
My appointment expires: ___ b .... / __ 13 ___ ( __ 2. t_.__ __________ _
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Property address: 4304 SE 3rd Street, Renton, WA 98059
Parcel# 3211000130
Legal Description: HEATHER DOWNS DIV #1, Plat Block: 1, Plat Lot: 13