HomeMy WebLinkAboutSigned Master Application'·.~. ! fAiiE ~·
DEPARTMEN T OF COMMUN ITY
AN D ECON OMIC DEVELOPMEN T
Planning Division
1055 South Grady Way, 6th Floor I Renton, WA 980571 425-430-7200
www.rentonwa.gov
LAND USE PERMIT MASTER APPLICATION ...
PROPERTY OWNER(S) PROJECT INFORMATION
NAME· . Ellen Kampel PROJECT OR DEVELOPMENT NAME:
Kamoel 20221114
ADDRESS: 4101 Williams Ave N PROJECT/ADDRESS{S)/1..0CATION AND ZIP CODE:
4101 Williams Ave N
CITY: Renton I STATE: lt~ss Wa
Rerton, WA 98056
PHONE NUMBER: (42S) 442_2264 KING COUNTY ASSESSOR'S ACCOUNT NUMBER($}
EMAIL ADDRESS .. -ellenkampel@hotmail.com 0 I prefer to receive all correspondence via US Mail.
APPLICANT (if other than owner) EXISTING LAND USE(S):
-
NAME: Christine Leonard PROPOSED LAND USE(S):
COMPANY (ifapplicable)p ific Arbo . ltu ac ncu re
EXISTING COMPREHENSIVE PLAN MAP DESIGNATION:
-
ADDRESS: 5101 S 372nd St PROPOSED COMPREHENSIVE PLAN MAP
DESIGNATION (if applicable) .,
CITY· I STATE: 19i'&>1 ·Auburn Wa
EXISTING ZONING:
PHONE NUMBER: (2Q6) g09-2170 PROPOSED ZONING (if applicable}
EMAIL ADDRESS*office@pacificarboriculture.com
D I prefer to receive aN corresoondence via US Mail.
SITE AREA (in square feet): . -
CONTACT PERSON SQUARE FOOTAGE OF PRIVATE ACCESS EASEMENTS:
NAME: Christine Leonard SQUARE FOOTAGE OF PUBLIC ROAfNVAYS TO BE
DEDICATED:
COW'ANY (if applicable)p "fj Arbo . ltu acr c ncu re
PROPOSED RESIDENTIAL DENSITY IN UNITS PER NET
ACRE (if applicable)
ADDRESS: 5101 S 372nd St NUMBER OF PROPOSED LOTS (if applicable)
CITY:A b I STATE: ,9~b()1 u urn Wa
NUMBER OF NEW DWEUING UNITS (if applicable):
PHONE NUMBER (20S) 909_2170 NUMBER OF EXISTING DWELLING UNITS (if applicable):
EMAIL ADDRE~•:office@pacificarboriculture.com D I prefer to receive all corresoondence via US Mail.
PROJECT VALUE:
*By completing the email address field the owner/applicant/contact person Is opting to receive all formal notifications
• • • •• •• • r • • •
PROJECT INFORMATION (CONTINUED)
IS THE SITE LOCATED IN ANY TYPE OF SQUARE FOOTAGE OF PROPOSEb RESIDENllAL
BUILDINGS (if applicable): ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE
SQUARE FOOTAGE OF EXISTING RESIDENTIAL
BUILDINGS TO REMAIN (if applicable):
SQUARE FOOTAGE OF PROPOSED ~ESIOENTIAL
BUILDINGS (if applicable):
SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL.
BUILDINGS TO REMAIN (if appflcable):
NET FLOOR AREA ON NON-RESIDENTIAL BUILDINGS (if
applicable):
NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE
I NEW PROJECT (if applicable):
SQUARE FOOTAGE (If applicablet,
AQUIFER PROTECTION AREA ONE
D AQUIFER PROTECTION AREA lWO
D FLOOD HAZARD AREA
GEOLOGIC HAZARD
HABITAT CONSERVATION
SHORELINE STREAMS & LAKES
WETLANDS
LEGAL DESCRIPTION OF PROPERTY
_sq.ft.
__ sq.ft.
--sq. ft.
--sq.fl
__ sq.ft.
(Attach leaal descriotion on separate·sheet with the following infonnation included}
SITUATE IN lHE ____ QUARTER OF SECTION_, TONNSHIP __ f.i, RANGE ___ __,W.M. IN THE CITY
OF RENTON, KING COUNTY, WASHINGTON
I AFFIDAVIT OF OWNERSHIP ..
/' _J . r ~~w::r ·--~
I, (Print Narrelsp f e Vf..._..,. ,.,~ { declare under pen~f 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 D the authorized representative to act for a
corporation (please a proof of authorization) and that the foregoing statements and answers herein contained and the infonnation
_. mffld, p ~-~~mfuebffl~~•:::a~ I
Signature of Owner/Representative "4 S D te Signature of~entative
A.\.( foC.,.) \ STATE OF .. WAHr.:!ISFnt:otl<TIN{3~T..,.Ol""'IJn J I" ) ss
COUNTY OF~ ) ••1 ' '1'-rit-k ..
I certify that I know or have &atit.factory evidence that t. ~.,J t 6\,..-t H '>Ir le~ U bO ~igned this instrument and
acknowledge it to be his/her/their free and voluntary .act for the ut.es and purp9se mentioned in the instrument
0~\ 3• j v,J,,</ Nota~the Stale.,_.,_ Z!j!-~ f1,l.il' •'
le~.· : ft ft ftME:1s: ~o7 ft ft J
; ; . Noury Public • C,iiforni1
il ~· V•ntur, County ii
.. ,-...· . Commission, 2289364 -
My Camm. Expir,s ~Y 20, 2023
Notary (Print):
My appointment expires:
I
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