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Home My WebLink AboutA_Master Application_190725_v1.pdfPROJECTINFORMATIONPROJECTORDEVELOPMENTNAME:\!GcsjPROJECT/ADDRESS(S)/LOCATIONANDZIPCODE:\]o2Xf&S\Jfs°ioSSKINGCOUNTYASSESSOR’SACCOUNTNUMBER(S):HoozSEXISTINGLANDUSE(S):SI•E,gic\Th\\:lPROPOSEDLANDUSE(S):Sw)E,1ow1\1PrintFormResetFormSaveForm—S.DEPARTMENTOFCOMMUNITYANDECONOMICDEVELOPMENTPlanningDivision1055SouthGradyWay,6thFloorIRenton,WA98057I425-430-7200www.rentonwa.govLANDUSEPERMITMASTERAPPLICATIONPROPERTYOWNER(S)NAME:ADDRESS:\1OcSE.CITY:.‘)STATE:ZIP:Qui1WA9oSSPHONENUMBER:4O(c.EMAILADDRESS*:SOSV&\%fDc:(oociIprefertoreceiveallcorrespondenceviaUSMail.APPLICANT(ifotherthanowner)NAME:COMPANY(ifapplicable):ADDRESS:CITY:STATE:ZIP:PHONENUMBER:EMAILADDRESS*:i:IprefertoreceiveallcorrespondenceviaUSMail.CONTACTPERSONNAME:31\cG.\COMPANY(ifapplicable):oriQc.\siç,ADDRESS:aIotO’S.CITY:%(STATE:IZIP:csli)OOQS\i’HPHONENUMBER93EMAILADDRESS*:Q\5c.ap’:)(orri:IprefertoreceiveallcorrespondenceviaUSMail.EXISTINGCOMPREHENSIVEPLANMAPDESIGNATION:PROPOSEDCOMPREHENSIVEPLANMAPDESIGNATION(ifapplicable)EXISTINGZONING:PROPOSEDZONING(ifapplicable):______SITEAREA(insquarefeet):—j,SQUAREFOOTAGEOFPRIVATEACCESSEASEMENTS:0SQUAREFOOTAGEOFPUBLICROADWAYSTOBEDEDICATED:PROPOSEDRESIDENTIALDENSITYINUNITSPERNETACRE(ifapplicable)NUMBEROFPROPOSEDLOTS(ifapplicable)oNUMBEROFNEWDWELLINGUNITS(ifapplicable):NUMBEROFEXISTINGDWELLINGUNITS(ifapplicable):PROJECTVALUE:(,,øooc::*Bycompletingtheemailaddressfieldtheowner/applicant/contactpersonisoptingtoreceiveallformalnotificationsandprojectdocumentsindigitalformatviaemailunlessotherwiserequested. IPROJECTINFORMATION(CONTINUED)SQUAREFOOTAGEOFPROPOSEDRESIDENTIALISTHESITELOCATEDINANYTYPEOFBUILDINGS(ifapplicable):ENVIRONMENTALLYCRITICALAREA,PLEASEINCLUDESQUAREFOOTAGE(ifapplicable):SQUAREFOOTAGEOFEXISTINGRESIDENTIALBUILDINGSTOREMAIN(ifapplicable):(LIAQUIFERPROTECTIONAREAONESQUAREFOOTAGEOFPROPOSEDNON-RESIDENTIALLIAQUIFERPROTECTIONAREAiWOBUILDINGS(ifapplicable):—DFLOODHAZARDAREAsq.ft.SQUAREFOOTAGEOFEXISTINGNON-RESIDENTIALBUILDINGSTOREMAIN(ifapplicable):E1GEOLOGICHAZARDsq.ft.NETFLOORAREAONNON-RESIDENTIALBUILDINGS(ifEJHABITATCONSERVATIONsq.ft.applicable):E:SHORELINESTREAMS&LAKESsq.ft.NUMBEROFEMPLOYEESTOBEEMPLOYEDBYTHENEWPROJECT(ifapplicable):JWETLANDSsq.ft.FLEGALDESCRIPTIONOFPROPERTYI(Attachlegaldescriptiononseparatesheetwiththefollowinginformationincluded)SITUATEINTHESQUARTEROFSECTION_____,TOWNSHIP3N,RANGE5,W.M.INTHECITYOFRENTON,KINGCOUNTY,WASHINGTONIAFFIDAVITOFOWNERSHIPISignatureofOwner/Repe‘entativeSTATEOFWASHINGTONCOUNTYOFKING)SSIcertifythatIknoworhavesatisfactoryacknowledgeittobehis/her/theirfree..çjcic%‘I,(PrintName/s)Ucx’cs,declareunderpenaltyofperjuryunderthelawsoftheStateofWashingtonthatIam(pleasecheckone)EhecurrentownerofthepropertyinvolvedinthisapplicationorQtheauthorizedrepresentativetoactforacorporation(pleaseattachproofofauthorization)andthattheforegoingstatementsandanswershereincontainedandtheinformationherewithareinIIrespectstrueandcorrecttothebestofmyknowledgeandbelief.________________DateSignatureofOwner/RepresentativeDateDatedsignedthisinstrumentandMyappointmentexpires: