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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: Morany Ngy
ADDRESS:24203 36th Ave S
CITY: Kent zip: 98032
TELEPHONE NUMBER: 206-351-0196
APPLICANT (if other than owner)
NAME:
COMPANY (if applicable):
ADDRESS:
CITY: ZIP:
TELEPHONE NUMBER:
CONTACT PERSON
NAME: Dan TOuma
COMPANY (if applicable):TOUma Engineers
ADDRESS: 255 SW 41st St.
CITY: Renton ZIP: 98057
TELEPHONE NUMBER AND EMAIL ADDRESS:
425-251-0665/Toumaengineering@gmaii.com
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Ngy Lot Line Adjustment
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
008700-0133 and 008700-0135
EXISTING LAND USE(S):
Single family
PROPOSED LAND USE(S):
single familiy
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
R-8
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
EXISTING ZONING:
R-8
PROPOSED ZONING (if applicable):
SITE AREA (in square feet):
18, 039.0
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
N/A
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
N/A
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
NIA
NUMBER OF PROPOSED LOTS (if applicable)
N/A
NUMBER OF NEW DWELLING UNITS (if applicable):
N/A
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017
PROJECT INFORMA
NUMBER OF EXISTING DWELLING UNITS (if applicable):
1
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable): N/A
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): 1 160 Sgft
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
TION continued
PROJECT VALUE:
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
❑ FLOOD HAZARD AREA sq. ft.
❑ GEOLOGIC HAZARD sq. ft.
❑ HABITAT CONSERVATION sq. ft.
❑ SHORELINE STREAMS & LAKES sq. ft.
❑ WETLANDS sq. ft.
LEGAL DESCRIPTION OF PROPERTY
(Attach leaal description on separate sheet with the following information included)
SITUATE IN THE SW QUARTER OF SECTION 29 , TOWNSHIP 23 , RANGE 5 IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Marany Ngy 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.
Signature of Owner/Representative Dat
STATE OF WASHINGTON )
) SS
COUNTY OF KING 1
I certify that I know or have satisfactory evidence that M6(—C4n
acknowledge it to be his/herltheir free and voluntary act for the uses
512�v�
Dated
DAN TOUMA
NOTARY PUBLIC
STATE OF WASHINGTON
COMMISSION EXPIRES
APRIL 28, 2021
Signature of Owner/Representative Date
`"_ v\ signed this instrument and
urpose mentioned in the instrument.
is in and for the State of Washington
Notary (Print):
My appointment expires: 4k17.s 17-1
2
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017
LEGAL DESCRIPTION OF PROPERTY
(Attach leaal description on separate sheet with the following information included)
SITUATE IN THE SW QUARTER OF SECTION 29 , TOWNSHIP 23 , RANGE 5 IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Marany Ngy 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.
Signature of Owner/Representative Dat
STATE OF WASHINGTON )
) SS
COUNTY OF KING 1
I certify that I know or have satisfactory evidence that M6(—C4n
acknowledge it to be his/herltheir free and voluntary act for the uses
512�v�
Dated
DAN TOUMA
NOTARY PUBLIC
STATE OF WASHINGTON
COMMISSION EXPIRES
APRIL 28, 2021
Signature of Owner/Representative Date
`"_ v\ signed this instrument and
urpose mentioned in the instrument.
is in and for the State of Washington
Notary (Print):
My appointment expires: 4k17.s 17-1
2
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017
Print 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: Teng Ngy
ADDRESS:
CITY: ZIP:
TELEPHONE NUMBER: 206-3-551-3114
APPLICANT (if otherthan owner)
NAME:
COMPANY (if applicable):
ADDRESS:
CITY: ZIP:
TELEPHONE NUMBER:
CONTACT PERSON
NAME: Dan TOuma
COMPANY (if applicable):TOuma Engineers
ADDRESS: 2555 SW 41st St.
CITY: Renton ZIP: 98067
TELEPHONE NUMBER AND EMAIL ADDRESS:
425-251-0665/Toumaengineering@gmaii.com
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Ngy Lot Line Adjustment
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
008700-0133 and 008700-0135
EXISTING LAND USE(S):
Single family
PROPOSED LAND USE(S):
single familiy
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
R-8
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION
(if applicable)
EXISTING ZONING:
R-8
PROPOSED ZONING (if applicable):
SITE AREA (in square feet):
18, 039.0
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
N/A
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
N/A
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
N/A
NUMBER OF PROPOSED LOTS (if applicable)
N/A
NUMBER OF NEW DWELLING UNITS (if applicable):
N/A
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017
PROJECT INFORMA
NUMBER OF EXISTING DWELLING UNITS (if applicable):
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable): N/A
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): 1160 Sgft
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
TION continued
PROJECT VALUE.
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
❑ FLOOD HAZARD AREA sq. ft.
❑ GEOLOGIC HAZARD sq. ft.
❑ HABITAT CONSERVATION sq. ft.
❑ SHORELINE STREAMS & LAKES sq. ft.
❑ WETLANDS sq. ft.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE SW QUARTER OF SECTION 29 , TOWNSHIP 23 , RANGE 5 IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Teng Ngy , 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.
Signature of 01& r/Repative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that l '
acknowledge it to be his/her/their free and voluntary act for the useA and
3�2�1�
Dated Notar ub
®ZTOUMANOSTATCOMA
Signature of Owner/Representative Date
signed this instrument and
mentioned in the instrument.
is in and for'the State of Washington
Notary (Print):
My appointment expires: 417-a ki
2
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE SW QUARTER OF SECTION 29 , TOWNSHIP 23 , RANGE 5 IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) Teng Ngy , 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.
Signature of 01& r/Repative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that l '
acknowledge it to be his/her/their free and voluntary act for the useA and
3�2�1�
Dated Notar ub
®ZTOUMANOSTATCOMA
Signature of Owner/Representative Date
signed this instrument and
mentioned in the instrument.
is in and for'the State of Washington
Notary (Print):
My appointment expires: 417-a ki
2
H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 10/2017