HomeMy WebLinkAboutA_MasterLandUseForm_190128_v1DEPARTMENT OF COMMUNITY --Owm�- CITY OF
AND ECONOMIC DEVELOPMENT
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Planning Division
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
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AD3E3Ss0-.-7 M -17I11 VIaAfAVE 111j.
CITY:ZIP: q
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TELEPHONE NUMBER: 7-6(oO 2-77 1- 5ZZ�3
APPLICANT (if other than owner)
NAME:
COMPANY (if applicable):
ADDRESS:
CITY: ZIPS
TELEPHONE NUMBER:
CONTACT PERSON
NAME: L—V-3� ) G�tHT0t I
COMPANY (if applicable)):
ADDRESS:
l-rAvE-
CITY: NL ZIP SOS
TELEPHONE NUMBER AND EMAIL ADDRESS:
266P 27 --:�) 23 3
L 1SALAV& [4-�t L.F-:E ( C-1 HTC)
PROJECT INFORMATION
PROJECT QR;DEVELOPMENT NAME:
Loco Hi -o" 2.a5 ID Eur
PROJECT/ADDR•ESS(S)/LOCATION AND ZIP CODE:
)5o7 mrm V I ew Ave: W .
)GING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
EXISTING LAND USE(S):
Sl r,161 LZ -FA VI I L—y IZES 1
PROPOSED LAND USE(S).-
q--
SE(S):q-- rml Lf jE�� I DE -Kr s
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
'ZeSI'DE;WTIAL. IFDIL)" DENSITY
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable) W /A
EXISTING ZONING:)
PROPOSED ZONING (if applicable):
N A
SITE AREA (in square feet):
2-91236n
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED: N /A
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
7'4 3
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable) 2.195
NUMBER OF PROPOSED LOTS (if applicable)
I
NUMBER OF NEW DWELLING UMTS (if applicable):
l
H:\CED�Data\Forms-Templates\5elf-Help Handouts\Planning\Master Application.doc Rev. 08/2015
IffiWECT INFOR
NUMBER OF EXISTING DWELLING UNITS (d applicable):
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (it. applicable).
SQUARE FOOTAGE OF PROPOSE[) NON-RESIDENTIAL
E3UILDINGS (lf applicable): .500
SQUARE FOOTAGE"OF EXIS-HN .G.f� 6N-RESIDEN' TIIAL
BUILT]INGSTOREMAIN'(Nfapplicable)-
NET FLOOR AREA ON NON-RESIDENTIAL SUIL:DINGS (if
applicable)_
NUMBER OF EMPLOYEES TO 13E EMPLOYED BY THE NEW
PR03ECT.C�i.apPNicabfe}:
MATION continued
PROJECT VALU E:
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY .CRITICAL AREA; PLEASE INCLUDE
SOPARE FOOTAGE (it applicable):
❑
AQUIFIER PROTECTION. AREA: ONE
[l
AQUIFIER PROTECTION AREA. TWO .
❑:
FLOOD HAZARD AREA-
❑
GEOLOGIC HAZARD
sq_
❑
HABITAT CONSERVATION
sq ft
-
SHORELINE STREAMS & LAKES . ;���Z�.(Csq. ft
❑
WETLANDS.
sq. ff.
LEGAL DESCRIPTION OF PROPERTY
Attach le aI description on se crate sheet with the following information included
SITUATE IN THE QUARTER OF SECTION , TOWNSHIP f RANGE _ IN THE CITY
OF RENTON, KING.COUNTY, WASHINGTON 'Ce '4TT, CJ-4ED
AFFIDAVIT OF 6WNERSH P
LISA LA✓AL_L- t(-. Lo -1 Q E-t-rol j
I, (Print Names} declare under pe.naftygf perjury under the laws of the State of Washiington that I am (please: check one
current owner of the property involved iri th►s`application or ❑ the authorized representative to act for corporation (pwase:attach�proaf .
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,
2 1 2
Sign re of O pre five ate
SOo
Representative Date
STATE OF WASHINGTON }
COUNTY OF KING � SS
I certify that I know or have satisfactory evidence that V-1 L,_1Q%
acknowledge it to be his/herltheir free and voluntary act for me uses and purpos errtioned in the instrumentignedhis instrument and
Dated
Notarypublic in and for the State of Washington
SHERRIE TURNER 54 tr r ler To rn
NOTARY PUBLIC
8'IrATE OF Yf M+,�
COMM'SSION @�REg
__ JULY Z5, 2021
Notary (Print).
MY :appointment expires:
2
H.�CEIApata\Farms. i errtpfateASelf-Help Handouts\Pfanning\MasterAppfication.doe
Rev: 08/2-