HomeMy WebLinkAboutA_Grinsell-Master Application_031121Print Form Rtset Form savt FvI rr,
DEPARTMENT OF COMMUNITY •
AND ECONOMIC DEVELOPMENT
Planning Division
1055 South Grady Way, 6th Floor I Renton, WA 98057 1 425-430-7200
www.rentonwa.eov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME Jason Grinsell
ADDRESS 999 Tacoma Ave Ne
CITY Renton
STATE:
Wa
ZIP.
98056
PHONE NUMBER (360) 620-2277
EMAIL ADDRESS' :jaysonl61 a@gmail.com
❑ I refer to receive all correspondence via US Mall.
APPLICANT (if other than owner)
NAME:
COMPANY (if applicable),
ADDRESS
CITY:
STATE:
ZIP
PHONE NUMBER.
EMAIL ADDRESS'
❑ I prefer to receive all correspondence via US Mad
CONTACT PERSON
NAME Jason Grinsell
COMPANY (if applicable)
ADDRESS 999 Tacoma Ave Ne
CITY Renton
STATE-
ZIP.
98056
PHONE NUMBER (360) 620-2277
EMAI L ADDRESS'jayson S 61 @gmail.com
❑ i refer to receive all corres on ence via US Mad
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Grinsell - Cedar Tree Removal
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
999 Tacoma Ave No, Renton Wa 98056
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S)
106150071004
EXISTING LAND USE(S):
Single Family (Res/Use Zone)
PROPOSED LAND USE(S):
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION
Residential Medium Density
PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable)
EXISTING ZONING,
R-8
PROPOSED ZONING (if applicable)
SITE AREA (in square feet):
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS
N/A
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED -
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
NUMBER OF PROPOSED LOTS (if applicable)
NUMBER OF NEW DWELLING UNITS (If applicable).
NUMBER OF EXISTING DWELLING UNITS (if applicable):
PROJECT VALUE:
`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.
PROJECT INFORMATION (CONTINUED)
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (€f applicable)
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable)
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable)
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (€f applicable).
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable)
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
NEW PROJECT (if applicable):
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 NE QUARTER OF SECTION 9 TOWNSHIP 23 N, RANGE 5 _,W M IN THE CITY
OF RENTON. KING COUNTY, WASHINGTON
I AFFIDAVIT OF OWNERSHIP
1, (Print Name/s) Jason Grinsell , declare under penalty of pegury 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 ❑ 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 ar all respe8true and correcto tff6Le of my knowledge and belief.
March 11, 20ai
Signature of OwnertRepresentative Date Signature of OwnerlRepresentative Date
STATE OF WASHINGTON )
) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that TAI;O-1 6 Zr- $ C, LL signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and urp s mentioned in the instrument.
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Dated 41ary ublic in and for the State of Washington
filD S So t1l Notary (Print):
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