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DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT
Planning Division
1055 South Grady Way, 6th Floor I Renton, WA 980571425-430-7200
www.rentonwa.gov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME: Liberty Ridge HOA
ADDRESS
CITY: Renton
ZIP: 98056
TELEPHONE NUMBER: (425) 283-5858
APPLICANT (if other than owner)
NAME:
GUMPANY (It applicable).
ADDRESS.
CITY: ZI P:
TELEPHONE NUMBER:
CONTACT PERSON
NAME: Nais Gutierrez, Association Manager
UUMHANY fir applicabie): Morris Management, Inc.
ADDRESS: 325 118th Avenue SE. Suite #204
CITY: Bellevue
ZIP: 98005
TELEPHONE NUMBER AND EMAIL ADDRESS:
(425) 283-5858
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME.
PROJECT/ADDRE S(S)/LOCATION AND ZIP CODE:
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
EXISTING LAND USE(S):
PROPOSED LAND USE(S):
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
EXISTING ZONING
PROPOSED ZONING (if applicable):
SITE AREA (in square feet):
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
NUMBER OF PROPOSED LOTS (if applicable)
NUMBER OF NEW DWELLING UNITS (if applicable):
1
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PROJECT INFORMATION (continued
NUMBER OF EXISTING DWELLING UNITS (if applicable):
PROJECT VALUE:
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
IS THE SITE LOCATED IN ANY TYPE OF
BUILDINGS (if applicable):
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
❑ AQUIFER PROTECTION AREA ONE
❑ AQUIFER PROTECTION AREA TWO
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable):
❑ FLOOD HAZARD AREA sq. ft.
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
❑ GEOLOGIC HAZARD sq. ft.
❑ HABITAT CONSERVATION sq. ft.
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable):
❑ SHORELINE STREAMS & LAKES sq. ft.
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable):
❑ WETLANDS sq ft.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the followina information included)
SITUATE IN THE QUARTER OF SECTION , TOWNSHIP , RANGE , 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 chec�.ne)�tl. current owner of the property involved in this application or F3q 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.
t�
Signature o e Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
Signature of Owner/Representative Date
I certify that I know or have satisfactory evidence that Qo�ts 6y-1 teyya_ signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrument.
3W
Dated
Notary Public
State of Washington
CATHY S LEMON
My Appointment Expires Dec 11, 2019
Notary Public in
the State of Washington
O�c&LAS C..erncN�
Notary (Print):
appointment expires: L
z
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017