2010-09-30 HEX# 10-007 Exhibit Brn r"N MASTER Lix. D USE APPLICATION
REC l— 1 DEPAR-rmE,,iT OF COiti muN rry DEVELOPMENT SERVICES
CITY OF
33325 8'h
(M�un[� aL FederalWay
APPLICATION NO(S) I b 59 9— l ^ 1 Q0(POO - S
Project Name . _ �2 a ! L 0I/
Property Address/Location
Avenue South
3-835-2507; Fax253-835-2509
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�x����� � Po Box ��ls
CC ff��jj Way WA 98063-9718
-� ;'�F` F��._ .cityaffederalway.com
CDS
Date U
( IJ
17.E
Parcel Number(s) �b�Id 1 7 3� V
i�
Project Description � 07)-7)
V
PLEASE PRTW
Type of Permit Required
Annexation
Binding Site Plan
Boundary Line Adjustment
Comp PI zone
Land Surface Modification
Lot Line Elimination
Preapplication Conference
Process I (Director—s Approval)
Process II (Site Plan Review)
Process III (Project Approval)
V Process IV (Hearing Examiner's Decision)
Process V (Quasi -Judicial Rezone)
Process VI
SEPA w/Project
SEPA Only
Shoreline: Variance/Conditional Use
Short Subdivision
Subdivision
Variance: Commercial/Residential
Required Information
r�
Zoning Designation
rtipfeh �s�fve lain Desi� tong
/• Value of Existing Improvements
•�� 7M Value of Proposed Improvements
International Building Code (IBC):
i ` � i � Occupancy Type
V. (_ _ Construction Type
City/State:
Applicant
Name: Co M °'rI`47 �• iiU�`,�j
Address: Gli�1 VUl' `/6063
`�
Zip:
Phone: ZS'�- q41' �a
Fax:
Email:
Signature:
Agent (if dil�than Applicant)
Name: �j �� �- relit i f�
Address: l � b 24 4 7(o't� �-,,a_, (,)
City/State: � oc 3�
Zip:
Phone: 4 2 S 174, 4 70 �
Fax: 42� 77 G - � l 7 7
Email: r o wcana bPhuvcjn. Conn
Siafore: �a6C�r4.RGrtir��ti,� T��IT
Owner
Name: 5 vt (/Vl,e Cc CG�v�-
Address: '
City/State:
Zip:
Phone:
Fax:
Email:
Signature:
Bulletin #003 —August 18, 2004 Page 1 of I k:u-Iandouts\Master Land Use Application