HomeMy WebLinkAboutA_MasterApplication_221107_v1Print FormReset FormSave Form
OF CITY
DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
REN TON
Y
Planning Division
1055 South Grady Way, 6th Floor | Renton, WA 98057 | 425-430-7200
www.rentonwa.gov
LAND USE PERMIT MASTER APPLICATION
PROPERTY OWNER(S) PROJECT INFORMATION
NAME: KEKIC, ALICIA C PROJECT OR DEVELOPMENT NAME:
Hazard Cedar Removal
PROJECTIADDRESS(S)yLOCATION AND ZIP CODE:
16320 119TH AVE SE 98058
Front right corner of house
ADDRESS:16320 119TH AVE SE
cITY: Renton 058 ST
PHONE NUMBER: (702) 812-96996 KING COUNTY ASSESSOR'S ACcOUNT NUMBER(S):
EMAIL ADDRESS": aliciakekic @gmail.com
Oprefer to receive all correspondence via US Mail.
EXISTING LAND USE(S): APPLICANT (if other than owner)
NAME: Andrew Raines PROPOSED LAND USE(S):
COMPANY (if applicable): MTS EXISTING cOMPREHENSIVE PLAN MAP DESIGNATION:
ADDRESS 5730 highway pl #1 PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable)
ATE 98203 CITY:Everett EXISTING zONING:
PHONE NUMBER:206-747-59007 PROPOSED ZONING (if applicable):
EMAIL ADDRESS: SITE AREA (in square feet)
Oprefer to receive all correspondence via US Mail.
sQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
CONTACT PERSON
SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE
DEDICATED:
NAME: Andrew Raines
COMPANY (if applicable): PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
ADDRESS.5730 highway pl # 1 NUMBER OF PROPOSED LOTS (if applicable)
ATE 98203 CITY:Everett NUMBER OF NEW DWELLING UNITS (if applicable):
PHONE NUMBER 206-747-5907 NUMBER OF EXISTING DWELLING UNITS (if applicable):
EMAIL ADDRESS
O prefer to receive all correspondence via US Mail.
PROJECT VALUE:
TBD
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)
IS THE SITE LOCATED IN ANY TYPE OF
ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
sQUARE FOOTAGE (f applicable)
sQUARE FOOTAGE OF PROPOSED RESIDENTIAL
BUILDINGs (if applicable):
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
AQUIFER PROTECTION AREA ONE BUILDINGS TO REMAIN (if applicable):
AQUIFER PROTECTION AREA TWO SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL
BUILDINGS (if applicable) FLOOD HAZARD AREA sq. ft.
sQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL
GEOLoGIC HAZARD sq. ft. BUILDINGS TO REMAIN (if applicable):
HABITAT CONSERVATION sq. ft. NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable) SHORELINE STREAMS & LAKES sq. ft.
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
OWETLANDS . ft. NEW PROJECT (if applicable):
LEGAL DESCRIPTION OF PROPERTY
(Attach legal description on separate sheet with the following information included)
QUARTER OF SECTION TOWNSHIP N, RANGE w.M. IN THE CITY SITUATE IN THE
OF RENTON, KING COUNTY, WASHINGTON
AFFIDAVIT OF OWNERSHIP
1, (Print Name/s) KEKIC, ALICIA c
am (please check one) the current owner of the property involved in this application orthe authorized representative to act for a
corporation (please attach proof of authorization) and that the foregoing statements
herewith are in all respects true and correct to the best of my knowledge and belief.
declare under penalty of perjury under the laws of the State of Washington that
nd answers herein contained and the information
1o10 202
Signature of Owner/Representative Signature of Owner/Representative Date Date
STATE OF WASHINGTON
S
COUNTY OF KING
I certify that I know or have satisfactory evidence that Alicia LekIC
acknowledge it to be his/her/their free and voluntary act for the usesand purpose mentioned in the instrument
signed this instrument and
10 10. 022
Dated Notary Public im and Yor the State of Washington
FAIN oLLEEN
63
NOTARY
R ColeTol taiD
Notary (Print):
%-bG. 2024 PUBLIC My appointment expire:
.OMMIS EXPIRE STATE OF N
NI