HomeMy WebLinkAboutA_Master App Notarized_09302024CITY OF RENTON |PERMIT SERVICES
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
name:Jason Mgebroff pHone:Jason Mgebroftf
MAILING ADDRESS:2625 NE 23rd St.,Renton,WA 98056,USA EMAIL:Jmgebroff@gmail.com
preferto receive all correspondencevia US mail.
APPLICANT(if other than owner)
NAME:Mitch Flannery COMPANY(if applicable):
PHONE:253-548-6769 EMAIL:mflannery@northerncraftco.com
MAILING ADDRESS:2625 NE 23rd St.,Renton,WA 98056,USA
|prefer to receive all correspondencevia US mail.
CONTACT PERSON
NAME:Same as applicant COMPANY(if applicable):
PHONE:EMAIL:
MAILING ADDRESS:
|prefer to receive all correspondencevia US mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:#1952
PROJECT/ADDRESS(ES)AND PARCEL NUMBERS:NE 23rd St.,Renton,WA 98056,USA #0423059158
EXISTING LAND USE(S):Residential PROPOSED LANDuse(s):|Te@ removal
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
PROPOSED COMPREHENSIVE PLAN MAPDESIGNATION(if applicable):
EXISTING ZONING:R-8 PROPOSED ZONING:N/A
SITE AREA(in square feet):1 2950
SQUARE FOOTAGE OF PUBLIC ROADWAYSTO BE DEDICATED:()
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE(if applicable):
NUMBER OF PROPOSEDLOTS(if applicable):
NUMBER OF NEW DWELLING UNITS(if applicable):
NUMBEROF EXISTING DWELLING UNITS(if applicable):PROJECT VALUE:
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDINGS(if applicable):
SQUARE FOOTAGEOFEXISTING RESIDENTIAL BUILDINGS TO REMAIN(if applicable):
rentonwa.gov/permitservices |planningcustomerservice@rentonwa.gov |425-430-7294 10/24/2023 |Page 1 of 2
LAND USE PERMIT MASTER APPLICATION
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS(if applicable):
SQUARE FOOTAGEOF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN(if applicable):
NET FLOOR AREA ON NON-RESIDENTIALBUILDINGS(if applicable):
NUMBEROF EMPLOYEESTO 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):
(1 AQUIFER PROTECTION AREA ONE [1 AQUIFER PROTECTION AREA TWO
[1 FLOOD HAZARD AREA SQ.FT.[1 SHORELINE STREAMS &LAKES SQ.FT.
[1 GEOLOGIC HAZARD SQ.FT.[1 WETLANDS SQ.FT.
C1 HABITAT CONSERVATION SQ.FT.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE QUARTER OFSECTION TOWNSHIP N,RANGE ,
W.M IN THE CITY OF RENTON,KING COUNTY,WASHINGTON
AFFIDAVIT OF ae
I,(Print Name/s)—/)don Mashfe ,declare under penalty of perjury under the lawsofthe State of
Washington that |am (pleasecheck one)the current ownerof the property involvedin 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
i
Arisnature of Owner/Representative Date Signature of Owner/Representative Date
STATE OF WASHINGTON )
)SS
COUNTY OF KING )
|certify that |know or have satisfactory evidence thato>Wvehrot signed this instrument and
acknowledgeit to b€his)her/their free and voluntary act for the uses and purpose mentionedin the instrument.
wfaay!ZeDatedNotaryPublicinandfortheStateofWashington
RVANKOPP Ryan Kf
45NOTARYPUBLIC#230053
STATEOF WASHINGTON
MY COMMISSION EXPIRES
02-01-27
Notary(Print): Q2-0(-2027Myappointmentexpires:
rentonwa.gov/permitservices |planningcustomerservice@rentonwa.gov |425-430-7294 10/24/2023 |Page 2 of 2