HomeMy WebLinkAboutA_Master_Land_Use_Form_180621_v1.pdfPrint Form Reset Form Save Form
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: Chris Erickson - King County DNRP Parks Division
ADDRESS: 201 South Jackson Street, #700
CITY: Seattle ZIP: 98104
TELEPHONE NUMBER: 206-477-4564
APPLICANT (if other than owner)
NAME -
COMPANY (if applicable):
ADDRESS:
CITY: ZIPS
TELEPHONE NUMBER:
CONTACT PERSON
NAME: Stephanie Modjeski
COMPANY (if applicable): Otak, Inc.
ADDRESS: 2731 Wetmore Ave, #300
CITY: Everett ZIP: 98201
TELEPHONE NUMBER AND EMAIL ADDRESS:
425-493-5223 ext. 40185
stephanie.modjeski@otak.com
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
May Creek Trestle Project
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
300 feet west of N. 41 st Street, Renton WA 98056
Tax address: King County Parks - 201 S. Jackson St.
#700, Seattle WA 98104
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
Parcel #3224059005
EXISTING LAND USE(S):
Eastside Rail Corridor Regional Trail
PROPOSED LAND USE(S):
Trail bridge repair
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
Residential High Density
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
n/a
EXISTING ZONING:
R-10 - Residential 10 dwelling units per acre
PROPOSED ZONING (if applicable):
n/a
SITE AREA (in square feet)
3,483 sf
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
0 sf, n/a
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
n/a
PROPOSED RESIDENTIAL DENSITY IN•J)NITx5, PER NET
ACRE (if applicable) f '
n/a
NUMBER OF PROPOSED LOTSppNati eru
NUMBER OF NEW DWELLING UA ITS (if" IlO able):. t
n/a`'�►JHua:''R'
Rev: 10/2017
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc
PROJECT INFORMATION ,(continued
NUMBER OF EXISTING DWELLING UNITS (if applicable)
n/a
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable):
n/a
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): n/a
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable): n/a
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): n/a
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable): n/a
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable): n/a
PROJECT VALUE:
$119,950
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
❑ AQUIFER PROTECTION AREA ONE
❑ AQUIFER PROTECTION AREA TWO
0 FLOOD HAZARD AREA 1,000 sq. ft.
❑ GEOLOGIC HAZARD sq. ft.
❑ HABITAT CONSERVATION sq. ft.
E1 SHORELINE STREAMS & LAKES 550 sq. ft.
❑ WETLANDS sq. ft.
LEGAL DESCRIPTION OF PROPERTY
ttach leaal description on separate sheet with the followina information included
SITUATE IN THE NW QUARTER OF SECTION 32 , TOWNSHIP 24N, RANGE 05E, IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) W t V L1 A,ek- t G . AC-yc v— declare under penalty of perjury under the laws of the State of
Washington that I am (please check one) the current owner of the property involved in this application or Q 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.
8 !S
Signature of Owner/Representative Date Signature of Owner/Representative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KINGJA certify that I know or have satisfactory evidence that .'ll 1 �' C -P r) �V signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in the instrumj N.
Notary Public in and for the State f Washington
9 N
�OTAq Notary (Print):
-00
_ ��8�•�ri : 2 My appointment expires:
'h°oeoeo
r WASH? 2
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017