HomeMy WebLinkAboutA_Land Use Master Application 180622 v1DEPARTMENT OF COMMUNITY CITY OF
AND ECONOMIC DEVELOPMENT ---RooRelnton
NbOF
Planning Division
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNERS}
NAME: �`�qI/I,p r)
ADDRESS:G`Q� !V E SA f 1
CITY: ZIP:
TELEPHONE NUMBER: ,20& _ 3�d
APPLICANT (if other than owner)
NAME:
COMPANY (if applicable):
ADDRESS:
CITY: ZIP:
TELEPHONE NUMBER:
CONTACT PERSON
NAME:
COMPANY (if applicable):
ADDRESS:
CITY: �ilAy,pil�l, ff ZIP:
TELEPHONE MBIcc.. NUMBER AND EMAIL ADDRESS:
zPe*• 5?0.52-7Y
eyi ��rvi.S iG .Cr'1a�
Dr►L .
ly
PROJECT INFORMATION
PROJECT OR DEVELOPMENT NAME:
C
PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE:
24�;o�.v N 5
e"-�7LOvt a* 6C66
KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S):
Z7f0Q4�31
EXISTING LAND USE(S): l hvlq— .�-q�r��.li
PROPOSED LAND USES) ,�OSe f ��
EXISTING COMPREHENSIVE PLAN M-/AP DESIGNATION:
,
PROPOSED COMPREHENSIVE PLAN MAP DESIGNATI N
(if applicable)
EXISTING ZONING:
PROPOSED ZONING (if applicable):
SITE AREA (in square feet):
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
NUMBER OF PROPOSED LOTS (if applicable)
NUMBER OF NEW DWELLING UNITS (if applicable):
t/
H:\CED\Data\Forms-Ternplates\Self-Help Handouts\Planning\Master Applicatian.doc Rev: 08/2015
PROJECT INFORMAI
NUMBER OF EXISTING DWELLING UNITS (if applicable):
SQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):, /,AW1
11
SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
NET,FL,QOR•;A ON NON-RESIDI`NT� L BUILDINGS (if
applicable):.
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW
PROJECT (if applicable):
ION continued
PROJECT VALUE:
G�
G'
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE (if applicable):
❑ AQUIFIER PROTECTION AREA ONE
❑ AQUIFIER PROTECTION AREA TWO
❑"=;,FLODD}HAZARD AREA M µtip, sq. ft.
❑ GEOLOGICHAZARD r sq. ft.
❑ HABITAT CONSERVATION sq. ft,
❑._'SHORELINE STREAMS & LAKES,. . , .. sq. ft,
❑ -WETLANDS
sq. ft.
LEGAL DESCRIPTION OF PROPERTY
Attach le 'al,descri lion on separate sheet with the following information included
SITUATE IN THE QUARTER OF SECTION TOWNSHIP , RANGE IN THE CITY
OF PEkrOF4, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
I, (Print NameJs) 4cYre under penalty of perjury under the laws of the State of Washington that I am (please check one) he
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 respects true
and corr r.- t he flay knor�Wledge'„and belief.
Si ire o vwrier Representative DrAte Signature of Owner/Representative Date
STATE OF WASHINGTON ) ,
) SS
COUNTY OF KING )
-
I certify that I know or have satisfactory evidence that �J `�� 'v r" signed this instrument and
acknowledge it to be his/€;94A4Wr free and voluntary act for the uses and purpose mentioned in the insfrurnent.
Date Notary ublic i and for the State of Washington_,' '
Notary Public �a C'
FWAPPointrmt
te of Washington
t5AC GOIEA Notary (Print): ,
a t-i
entExpires May 16, 2019
My appointment expires: �ka
2
H-.\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Master Application.doc Rev: 08/2a15