HomeMy WebLinkAbout03 - C - Master Application - HLDS - SignaturePROJECT INFORMATION (continued)
I,(Print Name/s)John D Wilson,declare under penalty of perjury 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 are in all
r spects true and correct to th b st of my knowledge and belief.
i
____________
ig ture of Ow’/Rereshtatk Signature of Owner/Representative
A EOF WASHINGTON
)SS
COUNTYOFKING )
I certify that I know or have satisfactory evidence tha\L_i-\L signed this instrument and
acknowledge it to be his/her/their free and voluntary affor the uses and purpose mentioned in the instrument.
Notary Public in and for thetate of Washington
I
3
H:\File Sys\WTR -Drinking Water Utility\WTR-13 -Studies &Project Development\WTR-13-0119 -Highlands 435 Zone Reservoir Replacement
Prelim Design\SEPA CUP Master Site\Master Application -HLDS.docRev:08/2015
NUMBER OF EXISTING DWELLING UNITS (if applicable):
0
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable):0
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):0
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable):45,561
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):55,191
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable):N/A
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable):0
PROJECT VALUE:
$13,981,000
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA,PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
LI AQUIFIER PROTECTION AREA ONE
AQUIFIER PROTECTION AREA TWO
LI FLOOD HAZARD AREA
____
sq.ft.
LI GEOLOGIC HAZARD
____
sq.ft.
LI HABITAT CONSERVATION
____
sq.ft.
LI SHORELINE STREAMS &LAKES
____
sq.ft.
LI WETLANDS
____
sq.ft.
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
SITUATE IN THE SE QUARTER OF SECTION 04,TOWNSHIP 23N,RANGE 05E,IN THE CITY OF
RENTON,KING COUNTY,WASHINGTON
AFFIDAVIT OF OWNERSHIP
Date Date
Dated
Notary (Print):
My appointment expires:(((9