HomeMy WebLinkAboutA_Master_Application_Matveyev_200908_v1.pdfDEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Planning Division
1055 South Grady Way, 6th Floor | Renton, WA 98057 | 425-430-7200
www.rentonwa.gov
*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.
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S) PROJECT INFORMATION
NAME: PROJECT OR DEVELOPMENT NAME:
ADDRESS: PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
CITY: STATE: ZIP:
PHONE NUMBER: KING COUNTY ASSESSOR’S ACCOUNT NUMBER(S):
EMAIL ADDRESS*:
I prefer to receive all correspondence via US Mail.
APPLICANT (if other than owner)EXISTING LAND USE(S):
NAME: PROPOSED LAND USE(S):
COMPANY (if applicable): EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
ADDRESS: PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable)
CITY: STATE: ZIP: EXISTING ZONING:
PHONE NUMBER: PROPOSED ZONING (if applicable):
EMAIL ADDRESS*:
I prefer to receive all correspondence via US Mail.
SITE AREA (in square feet):
CONTACT PERSON SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
NAME: SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
COMPANY (if applicable): PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
ADDRESS: NUMBER OF PROPOSED LOTS (if applicable)
CITY: STATE: ZIP: NUMBER OF NEW DWELLING UNITS (if applicable):
PHONE NUMBER NUMBER OF EXISTING DWELLING UNITS (if applicable):
EMAIL ADDRESS*:
I prefer to receive all correspondence via US Mail.
PROJECT VALUE:
PROJECT TNFORMATTON (CONT| NUED)
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable): 574
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable). p74
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable): p74
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): 574
NET FLOOR AREA ON NON-RESIDENTTAL BUILDtNGS (if
applicable): 1174
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
NEW PROJECT (if applicable): p74
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONIVENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable).
n nourrrn PRoTECTToN AREA oNE
E noul=n PRoTECTIoN AREA TWO
N FLooD HAZARDAREA
tr cEoloclc HAZARD
tr HABTTAT coNSERVATtoN
tl SHoRELTNE srREA[/s & LAKES
E wrrmruos
sq. ft.
sq ft.
sqft
sq ft.
sq. ft.
LEGAL DESCRIPTION OF PROPERTY
on sheet with the following information I
SITUATE IN THE NW QUARTER OF SECTION 32 , TOWNSHIP
OF RENTON, KING COUNTY, WASHINGTON
24 N, RANGE 05 _,W.M. lN THE CtTy
AFFIDAVIT OF OWNERSHIP
l, (Print Name/s)declare under penalty of pe4ury 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 Ithe authorized representative to act for a
corporation (please attach proof of authorization) and that the foregoing statements and answers herein contained and the information
herewrth are in all respects true and correct to the best of my knowledge and belief.
Signature of Owner/Representative Date
STATE OF WASHTNGTON J ^^)5b
couNTY oF K|NG )
I certify that I know or have satisfactory evidence that signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and in the instrument.
ol' 'L - zb2-o
Notary Public in and for the State of Washington
F-r,-.k <,y,th
Notary (Print):
Myappointmentexpires: 7- Z[,- LA"Z-Z
IRICK A SMITH
Noiary Public
Sr...te of Washington
Conrmission i 199701
Dated
*==a
Emil Matveyev