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HomeMy WebLinkAboutA_Master Application_Verizon SEA Classics Revision_200924_v1.pdfDEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT Planning Division 1055 South Grady Way, 6th Floor I Renton, WA 98057 I 425-430.-7200 www.rentonwa.gov LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) PROJECT INFORMATION NAME: Ramac Inc. PROJECT OR DEVELOPMENT NAME: Verizon Wireles-SEA Classics ADDRESS: 4607 Forest Ave SE PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: Installation of rooftop antennas and site support equipment CITY: Mercer Island STATE: ZIP: WA 98040 within a fenced compound adjacent to existing building. 2003 Maple Valley HWY, Renton, WA 98055. PHONE NUMBER: (425) 226-5900 KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): 1723059103 EMAIL ADDREss·:c;o Actualize LLC D I prefer to receive all corresoondence via US Mail. APPLICANT (if other than owner) EXISTING LAND USE(S): Office Building NAME: Actualize LLC OBO Verizon PROPOSED LAND USE(S): Telecommunications COMPANY (if applicable): EXISTING COMPREHENSIVE PLAN MAP DESIGNATION: Commercial-Office-Residential ADDRESS: 30 I h p· SE 20 ssaqua ine Lake Rd #538 PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) N/ A CITY: S . h STATE: ZIP: ammam1s WA 98057 EXISTING ZONING: COR PHONE NUMBER: (425 ) 429 _4287 PROPOSED ZONING (if applicable): N/A EMAIL ADDREss·:srent@Actualize-LLC.com D I prefer to receive all corresnondence via US Mail. SITE AREA (in square feet): 166.25 Sa. Ft. New fenced area. CONT ACT PERSON SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS: NAME: Brent Sutten SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: COMPANY (if applicable):Actualize LLC PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET ACRE (if applicable) N/ A ADDRESS: 3020 Issaquah Pine Lake Rd SE #538 NUMBER OF PROPOSED LOTS (if applicable) N/A CITY:S . h STATE: ZIP: ammam1s WA 98057 NUMBER OF NEW DWELLING UNITS (if applicable): N/A PHONE NUMBER (425 ) 429 _4287 NUMBER OF EXISTING DWELLING UNITS (if applicable): N/A EMAIL ADDREss·:srent@Actualize-LLC.com D I ore/er to receive all corresoondence via US Mail. PROJECT VALUE: $150,000 *By completing the email address field the owner/applicant/contact person is opting to receive all formal notifications and project documents in digital format via email unless otherwise requested. ~ I PROJECT INFORMATION (CONTINUED) I SQUARE FOOTAGE OF PROPOSED RESIDENTIAL IS THE SITE LOCATED IN ANY TYPE OF BUILDINGS (if applicable): N/A ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (if applicable): SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A D AQUIFER PROTECTION AREA ONE SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL D AQUIFER PROTECTION AREA TWO BUILDINGS (if applicable): N/ A D FLOOD HAZARD AREA __ sq.ft. SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL BUILDINGS TO REMAIN (if applicable): N/A D GEOLOGIC HAZARD __ sq.ft. NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if D HABITAT CONSERVATION __ sq.ft. applicable): N/ A 0 SHORELINE STREAMS & LAKES 166.25 sq. ft. NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT (if applicable): N/A D WETLANDS __ sq.ft. LEGAL DESCRIPTION OF PROPERTY (Attach lei:1al description on separate sheet with the followina information included) SITUATE IN THE SE QUARTER OF SECTION 17 , TOWNSHIP 23 N, RANGE 05 ,W.M. IN THE CITY OF RENTON, KING COUNTY, WASHINGTON ------- I AFFIDAVIT OF OWNERSHIP I I, (Print Name/s) 'Du.1>1 !' 'i:-1 C.. <;,'[~, Yi e. , declare under penalty of perjury under the laws of the State of Washington that I am (please check one) D the current owner of the property involved in this application or G;I 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 1 are in/II respe:4.:;;na.rrect to ;::est of my knowledge and belief. f ,>/1:;a#u.JIJ(JtI:.l: q _3_ ;;o'i,O ---~--------- S1/fue.ture of Owner/Representative Date Signature of Owner/Representative Date STATE OF WASHINGTON ) ) ss COUNTY OF KING ) I certify that I know or have satisfactory evidence that Vr,)rl )g j L , :::,he"' e... acknowledge it to be his/her/their free and voluntary act for the uses and purpose mentioned in th signed this instrument and instrument. Dated /} I -~ J~-- Notary Public i al'ldfor the Stat of ashington bvl.;'"'1 E, · ,) o~ I , ' Notary (Print): My appointment expires: