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TIT
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ICILIFILMED
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ROUTE SCHEDULE
PLANNING DEPARTMENT DATE ROUTED j/147$
PLEASE REVIEW THIS APPLICATION FOR:
REZONE MAJOR PLAT
SITE APPROVAL 4j(1: W4esiiv9i- \/ SHORT PLA.) /! d' - 77
SPECIAL PERMIT WAIVER
SHORELINE MANAGEMENT
PERMIT OR EXEMPTION
AND RETURN TO THE PLANNING DEPARTMENT
WITH ANY COMMENTS YOU MIGHT HAVE , BEFORE ; iY(IY
SIGNATURE
OR
INITAL DEPARTMENT APPROVAL DENIAL DATE
RAFFIC ENG. ) - 1c, —7c
ENGINEERING X
FIRE � : //l/7S .ram-"
HEALTH
/ J -JZ-i
REVIEWER ' S COMMENTS OR APPROVAL CONDITIONS :
, ,114 lA44-0 _ aLSNT Cir'i; �f So L fl eab1a I /1. „.4,:r3a- oM L4i j OAj
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/1 C/CG"/1-17? i Ze-1/G ' .
PLEASE SIGN THE E . I .W . :
ci
/ ' 1I,� I�,r. Y ..
,..,
_ __,
CITY OF:;RENTON
I/ SHORT PLAT PLAT APPLICATION
• FILE NO. //I- 7
MAJOR PLAT `t 0F DATE REC' D. 41-49.i 1
TENTATIVE '`` -/i APPLICATION FEE $ /00. Ta
�
PRELIMINARY RE S/16 Q\ ENVIRONMENTAL
1
FINAL �EC Z REVIEW FEE $ T/'`/
RECEIPT NO .
2 '� SM NO.
/44G OEPe PUD NO'
APPLICANT TO COMPLETE ITEMS 1 THROUGH 7:
1. Plat Name & Location /c3 ,`a' f? ,�1/yd Sim /3 6,. 94(Jp e
2 . No. Lots 2 Total Acreage / ,7 Zoning S '/
3 ., Owner V. 4NA r l Nii- en
Phone y.;i S-`- S q d'/
Address /c?v?c /08 sel'/Vie f3('//ecfdU , 41i9
5 . Underground Utilities : Yes No Not Installed
Telephone ( 1/) ( ) ( )
Electric ( '•/) ( ) ( )
Street Lights ( i/ ) ( ) ( )
Natural Gas ( V ) ( ) ( )
TV Cable ( ) ( ) ( )
6. Sanitation & Water:
( ✓ ) City Water ( ) Sanitary Sewers
( ) Water District No . ( ) Dry Sewers
( ✓ ) Septic Tanks
7. Vicinity and plat maps as required by Subdivision Ordinance.
8. DATE REFERRED TO:
ENGINEERING PARKS
BUILDING HEALTH
TRAFFIC ENG. STATE HIGHWAY
FIRE COUNTY PLANNING
BD. PUBLIC WORKS OTHER
_9 . STAFF ACTION:
TENTATIVE PLAT APPROVED DENIED
APPEALED EXPIRED
0. LAND USE HEARING EXAMINER'S ACTION:
SHORT PLAT APPROVED DENIED
PRELIMINARY PLAT APPROVED DENIED
__FINAL PLAT APPEALED EXPIRED
1 . CITY COUNCIL ACTION:
PRELIMINARY PLAT APPROVED DENIED
FINAL PLAT APPEALED EXPIRED
DEFERRED IMPROVEMENTS :
DATE DATE BOND NO. AND
TYPE GRANTED EXPIRES AMOUNT
Planning Dept .
Rau, 1 /77
4110
AFFIDAVIT
I, y061 , being duly sworn, declare that I
am the owner of the property nvolved in this application and that the
foregoing statements and answers herein contained and the information
herewith submitted are in all respects true and correct to the best of
my knowledge and belief.
Subscribed and sworn before me
this /5* day of ,bQ , 1977 ,
Notary Public in and for th State of
Washington, residing at
(ice
(Name Notary Public) (Signature of Owne
(Andress) 2- • '✓� 6/ �L• /0` g.- / w/v
(Address)
( k/1/
o FRECEIVED 'o � _ a
(City) (State)
DEC 29 1871
4'/4"
G DE ' -" (Telephone)
(FOR OFFICE USE ONLY)
CERTIFICATION
This is to certify that the foregoing application has been inspected by me
and has been found to be thorough and complete in every particular and to
conform to the rules and regulations of the Renton Planning Department
governing the filing of such application .
Date Received /
e-C-, �4/. , 197e/7 By:
Renton Planning Dept .
2-73
.ENDING
OF FILE
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