HomeMy WebLinkAboutA_Misty Cove_Transblue Seattle Land Use PermitPrint Form Reset Form Save Form
DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT k
TIOR
Planning Division ") W
1055 South Grady Way, 6th Floor I Renton, WA 98057 1 425-430-7200
www.rentonwa.gov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S)
NAME:
ADDR S: 09/AWS
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CITY,�}002/
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PHONE NUMBER: 0/0 Tb�P �q/iAe1Cm#hr-
EMAIL ADDRESS:
❑ I prefer to receive all correspondence via US Mail.
APPLICANT (if other than owner)
NAME: Clint Carr
COMPANY (if applicable)TranSblUe Seattle
ADDRESS:720 N 10th St, A394
CITY: Renton STATE: ZIP:
�98057
WA
PHONE NUMBER: (425) 873-8200
EMAIL ADDRESStransblueseattle@transblue.org
❑ I prefer to receive all correspondence via US Mail.
CONTACT PERSON
NAME: Clint Carr
COMPANY (if applicable)Transblue Seattle
ADDRESS:720 N 10th St, A394
CITY: STATE ZIP:
Renton �WA 1'98057
PHONE NUMBER (253) 204-5965
EMAIL ADDRESS*carrc@transblue.orq
❑ I refer to receive all correspondence via S Mail.
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
Misty Cove
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
5021 Ripley Lane N, Renton, 98056
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
56155-0000
EXISTING LAND USE(S):
I
ondo/Residential
PROPOSED LAND USE(S):
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable)
EXISTING ZONING:
PROPOSED ZONING (if applicable):
SITE AREA (in square feet):
16633
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
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:
$37,000
*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.
PROJECT INFORMATION (CONTINUED)
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL IS THE SITE LOCATED IN ANY TYPE OF
BUILDINGS (if applicable): ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
�SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): ❑ AQUIFER PROTECTION AREA ONE
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL ❑ AQUIFER PROTECTION AREA TWO
BUILDINGS (if applicable):
❑ FLOOD HAZARD AREA sq. ft.
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable): ❑ GEOLOGIC HAZARD sq. ft.
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if ❑ HABITAT CONSERVATION sq. ft.
applicable):
0 SHORELINE STREAMS & LAKES 86633 sq. ft.
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
NEW PROJECT (if applicable): ❑ WETLANDS sq. ft.
LEGAL DESCRIPTION OF PROPERTY
Attach legal description on separate sheet with the following information included
SITUATE IN THE SW QUARTER OF SECTION 29 TOWNSHIP 24 N, RANGE 5 ,W.M. IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print Name/s) %7*so 9 i'f kw, , declare under penalty of pedury under laws of the State of Washington that I
am (please check one) ❑ the current owner of the property involved in this application or LwIthe 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 are in all respects true and correct to the best of my knowledge and belief.
ignature of Owner/Representative Date Signature of Owner/Representative Date
Ft7r �s:ti�Y 4,ve, Af*&e 'Ac L
STATE OF WASHINGTON )
COUNTY OF KING SS
I certify that I know or have satisfactory evidence that �/acsDf'I /S� signed this instrument and
acknowledge it to be his/her/their free and voluntary act for the uses and p rpose mentioned in the instrument.
Dated tary P is in and f r the State of Washington
GAYLA HOCKER
Notary Ptfblic
State of Washington
License Number 178213
My Commission Expires
MAY 01, 2023
Notary (Print):
My appointment expires: aaa3