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DEPARTMENT OF COMMUNM 'IT, °r -
AND ECONOMIC DEVELOPMENT `—�
e ton � �.
AFFIDAVIT OF INSTALLATION OF
P" 'BLIlftor INFORMATION S!rN
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1055 South Grady Way, Renton, WA 98057
Phone: 425-430-7200 ] www.rentonwa.gov
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
1. I, "A - \a. Ac;1 �-LA -0af ti—) , certify under penalty of perjury under
the laws of the State of Washington that the foregoing is true and correct, being first
duly sworn on oath, deposes and says:
2. On the L day of 20 L_TI installed
ed
infor ntation si it(s) on thepropertylocated at %� 1, �
N g t l
for the following project: tZ s -f -I T4--)� k(-14 -r,
o
a� i�L3 tilDjg (:E:f7 Uhl
Project Name
Owner Name
3. i have attached a copy of the neighborhood detail map marked with an "X" to indicate
the location of the installed sign.
4. This/these public information sign(s) was/were constructed and installed in locations in
conformance with the requirements of Chapter 8 Tit e 4 of Renton Municipal Code and
the City's "Public Information Signs i n" do t package.
Installer ignature
SUBSCRIBED AND SWORN to bef re me is (6 -t day of 20 .
DOES LAN, NOTARY PUBLIC in and for the State of Washington,
residing at/EVGiA
My commission expires on 7=2� f'�
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t:\Users�c ip�/AC-* ( fc�Handouts�Pub Info Sign Handout.docx Rev. 02/2017
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