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Lindquist Master Application Form
AuthentisignID:6D27E186-6C2C4D53-B305-0F6D86F3398CPrintformResetFornSmieFormDEPARTMENTOFCOMMUNITY&ECONOMICDEVELOPMENTPlanningDivision1055SouthGradyWay,6thFloorIRenton,WA980571425-430-7200www.rentonwa.govLANDUSEPERMITMASTERAPPLICAJIONPROPERTYOWNER(S)-NAME:DavidLindquistADDRESS:654EastPickeringDriveCITY:SheltonZIP:98584TELEPHONENUMBER:(360)427-3100APPLICANT(ifotherthanowner)NAME:ToddLevittCOMPANY(ifapplicable):DBRHomesLLCADDRESS:14410BelRedRoadCITY:BellevueZIP:98007TELEPHONENUMBER:(425)644-2323CONTACTPERSONNAME:SameasApplicantInfoCOMPANY(ifapplicable):ADDRESS:CITY:ZiP:TELEPHONENUMBERANDEMAILADDRESS:IPROJECTINFORMATIONPROJECTORDEVELOPMENTNAME:LindquistLotsPROJECTIADDRESS(S)/LOCATIONANDZIPCODE:909/915N.29thStRenton,WA.98056KINGCOUNTYASSESSORSACCOUNTNUMBER(S):334210-0737/334210-0738EXISTINGLANDUSE(S):ResidentialSFDPROPOSEDLANDUSE(S):ResidentialSDFEXISTINGCOMPREHENSIVEPLANMAPDESIGNATION:ResidentialPROPOSEDCOMPREHENSIVEPLANMAPDESIGNAJ1ON(ifapplicable)N/AEXISTINGZONING:R-8PROPOSEDZONING(ifapplicable):N/ASITEAREAfinsquarefeet):5f00SFeachlotSQUAREFOOTAGEOFPUBLICROADWAYSTOBEDEDICATED:N/ASQUAREFOOTAGEOFPRIVATEACCESSEASEMENTS:N/APROPOSEDRESIDENTIALDENSITYINUNITSPERNETACRE(Ifapplicable)N/ANUMBEROFPROPOSEDLOTS(IfapplIcable)N/ANUMBEROFNEWDWELLINGUNITS(ifapplicable):2H:\CFD\Data\FormsTemplates\SeIf-HelpHandouts\Plnnlng\MasterAppllcatlon4ocRev:W/2017 AuthentisignID:6D27E1864C2C.4D53-B305-0F6D86F3398CPROJECTINFORMATION(continued)DavidLindquistI,(PrintName/a).declareunderpenaltyofpequryundlawsoftheStateofWashingtonthatIam(pleasecheckone)[ecurrentownerofthepropertyinvolvedinthisapplicationortheauthorizedrepresentativetoactforacorporation(pleaseattachproofofauthorIzation)andthattheforegoingstatementsandanswershereincontainedandtheinformationherewithareinallrespectstrueandcorrecttothebestofmyknowledgeandbelief.STATEOFWASHINGTON))SSIcertifythatIknoworhavesatisfactoryevidencethatS4dC..,.LiVi(1i)iI&4.signedthIsinstrumentandacknowledgeittobehlsTher/theirfreeandvoluntaryadfortheusesandpurposeentlonedintheInstrument.tO______otaryPublicinandfortheStateofashingtonAwiberKQ1.tvi.Notary(Print):COUNTYOFKINGNUMBEROFEXISTINGDWELLINGUNITS(ifapplicable):0SQUAREFOOTAGEOFPROPOSEDRESIDENTIAL.BUILDINGS(ifapplicable):Approx.3,600SFeachSQUAREFOOTAGEOFEXISTINGRESIDENTIALBUILDINGSTOREMAIN(ifapplicable):N/ASQUAREFOOTAGEOFPROPOSEDNON-RESIDENTIALBUILDINGS(ifapplicable):N/ASQUAREFOOTAGEOFEXISTINGNON-RESIDENTIALBUILDINGSTOREMAIN(ifapplicable):N/ANETFLOORAREAONNON-RESIDENTIALBUILDINGS(ifapplicable):N/ANUMBEROFEMPLOYEESTOBEEMPLOYEDBYTHENEWPROJECT(ifapplicable):N/APROJECTVALUE:2,000,000ISTHESITELOCATEDINANYTYPEOFENVIRONMENTALLYCRITICALAREA,PLEASEINCLUDESQUAREFOOTAGEfitapplicable):UAQUIFERPROTECTIONAREAONEUAQUIFERPROTECTIONAREAiWOOFLOODHAZARDAREA_____sq.ft.CIGEOLOGICHAZARD_____sq.ft.UHABITATCONSERVATION_____sq.ft.USHORELINESTREAMS&LAKES______sq.ft.OWETLANDS______sq.ft.LEGALDESCRIPTIONOFPROPERTY(Attachleg[descrIptiononseparatesheetwiththefollowinginformationIncluded)SITUATEINTHESWQUARTEROFSECTION32,TOWNSHIP._,RANGE_,INTHECITYOFRENTON,KINGCOUNTY,WASHINGTONIAFFIDAVITOFOWNERSHIPAuthenti:IfDauidj..&ndquiot10/20/2017hfwnsepresentatlveDateSignatureofOwner/RepresentativeDateDatedMyappointmentexpires:9/t/%0Q2H:\CED\Data\Forms-Templates\Seff-HelpHandouts\PlannlngMasterAppllcatlon.docRev:10/2017