HomeMy WebLinkAboutMiscDEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT -------Renton®
AFFIDAVIT OF INSTALLATION OF
PUBLIC INFORMATION SIGN
Planning Division
1055 South Grady Way, Renton, WA 98057
Phone: 425-430-7200 I www.rentonwa.gov
STATE OF WASHINGTON )
) ss
COUNTY OF KING )
S co---r, [)Av L5 being first duly
sworn on oath, deposes and says:
l. On the '2. 7--day of MA '1 20___l__!e, I installed
information sign(s) and plastic flyer box on the property
~3~5"_1_1_A1_1;;~--z_,.,~o_s:~,'----------for the following project:
Project Name
/ public
located at
Pu,,,,-, 'XN"'fJ /;;'"'1~'-"1 //2.,4-fJ10 t-Jtr,=r:...
Owner Name
2. I have attached a copy of the neighborhood detail map marked with an "X" to indicate
the location of the installed sign.
3. This/these public information sign(s) was/were constructed and installed in locations in
conformance with the requirements of hapter 7 itl
the City's "Public Information Signs s
lnsta er Signature
SUBSCRIBED AND SWORN to before me this 3)':j-, da~
~(___)
, 201..!2_.
NOTARY PUBLIC in and for the State of Washington,
residing at~ , \.,00
My commission expires on a{~ld---) fr I io/ g
7
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Pub Info Sign Handout.docx Rev. 04/2016