HomeMy WebLinkAboutDOE4_A_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: