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Langston LLA application 5-23-17
DEPARTMENTOFCOMMUNITYANDECONOMICDEVELOPMENT—Renton0PlanningDivisionLANDUSEPERMITMASTERAPPLICATIONPROPERTYOWNER(S)NAME:ADDRESS:iflCITY:rtdj3ZIP:TELEPHONENUMBER:APPLICANT(ifotherthanowner)NAME:COMPANY(ifapplicable):ADDRESS:CITY:ZIP:TELEPHONENUMBER:CONTACTPERSONNAME:COMPANY(ifapplicable):ADDRESS:CITY:ZIP:TELEPHONENUMBERANDEMAILADDRESS:-‘S/-74/&iZ€LeiØD0M’1PROJECTINFORMATIONPROJECTORDEVEOPMENTNAME:PROJECT/ADDESS(S)/LOCATIONANDZIPCODE:)3)&2’7//)S%uJVt)KINGCOUNTYASSESSORSACCOUNTNUMBER(S):3OO—‘//‘/I,éEXISTINGLANDUSE(S):PROPOSEDLANDUSE(S):EXISTINGCOMREENSIVEPLANMAPDESIGNATION:PROPOSEDCOMPREHENSIVEPLANMAPDESIGNATION(ifapplicable)71)EXISTINGZONING:‘130PROPOSEDZONING(ifapplicable):SITEAREA(insquarefeet):__—SQUAREFOOTAGEOFPUBLICROADWAYSTOBEDEDICATED:ySQUAREFOOTAGEOFPRIVTEACCESSEASEMENTS:PROPOSEDRESIDENTIALDENSITYINUNITSPERNETACRE(ifapplicable)NUMBEROFPROPOSEDLOTS(ifapplicable)NUMBEROFNEWDWELLINGUNITS(ifapplicabIe5:H:\CED\Data\Forms-Templates\SeIf-HeIpHandouts\Planning\MasterApplication.docRev:08/2015 PROJECTINFORMATION(continued)NUMBEROFEXISTINGDWELLINGUNITS(ifapplicable):SQUAREFOOTAGEOFPROPOSEDRESIDNTIALBUILDINGS(ifapplicable):SQUAREFOOTAGEOFEXISTINGRESIDENTIALBUILDINGSTOREMAIN(ifapplicable):SQUAREFOOTAGEOFPROPOSEDNON-RESIDENTIALBUILDINGS(ifapplicable):/4SQUAREFOOTAGEOFEXISTINGNOs(-RESIDENTlALBUILDINGSTOREMAIN(ifapplicable):/4NETFLOORAREAONNON-RESIDEttIALBUILDINGS(ifapplicable):f’L/iJNUMBEROFEMPLOYEESTOBEEMPLOYEDBYTHENEWPROJECT(ifappIicabPROJECTVALUE:ISTHESITELOCATEDINANYTYPEOFENVIRONMENTALLYCRITICALAREA,PLEASEINCLUDESQUAREFOOTAGE(ifapplicable):ElAQUIFIERPROTECTIONAREAONEElAQUIFIERPROTECTIONAREATWOElFLOODHAZARDAREAElGEOLOGICHAZARDElHABITATCONSERVATIONElSHORELINESTREAMS&LAKES[1WETLANDSsq.ft.sq.ft.sq.ft.sq.ft.sq.ft.I,(PrintName/s)_____,declareunderpenaltyofperjuryunderthelawsoftheStateofWashingtonthatIam(pleasecheckone)Elthecurrentownerofthepropertyinvolvedinthisapplicationorctheauthorizedrepresentativetoactforacorporation(pleaseattachproofofauthorization)andthattheforegoingstatementsandanswershereincontainedandtheinformationherewithareinallrespectstrueandcorrecttotheestofmyknowledgeandbelief.a3I7__________________STATEOFWASHINGTONSSCOUNTYOFKINGIcertifythatIknoworhavesatisfactoryevidencethatVAPç-Y?_C‘k-t-4’Z..%csignedthisinstrumentandacknowledgeittobehis/her/theirfreeandvoluntaryactfortheusesandpurposementionedintheinstrument.NotaryPublicirlandfortheStatWotWashington.]T141,&r—A-I/1-cNotary(Print):Myappointmentexpires:-I2LEGALDESCRIPTIONOFPROPERTY-(Attachlegaldescriptiononseparatesheetwiththefollowinginformationincluded)SITUATEINTHE____QUARTEROFSECTION____,TOWNSHIP____,RANGE____,INTHECTYOFRENTON,KINGCOUNTY,WASHINGTONAFFIDAVITOFOWNERSHIP-SignatureofOwner/RepresentativeDateSignatureofOwner/RepresentativeDateDatedH:\CED\Data\Forms-Templates\SeIf-HelpHaridouts\Planning\MasterApplicaticn.docRei:08/2015