2011-01-05 HEX# 10-008 Exhibit BCITY OF 14"::tSp
Federal Way
APPLICATION NO(S)
Project Name -�c
Property Address/Location =
Parcel Number(s) 4 t`
Project Description
PLEASE PRINT
Type of Permit Required
Annexation
Binding Site Plan
Boundary Line Adjustment
Comp Plan/Rezone
Land Surface Modification
Lot Line Elimination
Preapplication Conference
Process I (Director=s Approval)
Process II (Site Plan Review)
Process III (Project Approval)
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: £envnereiet /Residential
Required Inforrrmatii/onj �
ZdningDesignation
omprehensive Plan Designation
�y Value of Existing Improvements
V Value of Proposed Improvements
International Building Code (IBC):
I^ti Occupancy Type
� • --/ non -.ra-W Construction Type
MASTER LAND USE APPLICATION
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8`h Avenue South
PO Box 9718
Federal Way WA 98063-9718
253-835-2607;Fax 253-835-2609
%rtivw.cit ,offederalway.co[n
Date ---
010ty
Applicant
Name]
Address:_
City/State; kdl k{,(_,000d, ��l- ---
zip: ---9>- &-
Phone: -
Fax::9�� — - -
Email: �G �Fn of �1/1 C°. fY]�J1`? • l0 Ml
Signature: x1J
Agent (if different than Applicant) `�, I
Name: v i 0� �i3�i� bo 7, �Gi�•+�sr P G
Address: aD �.�—�DF( G AN 601 V
City/State: ''[:�IL C Nl a. (/J b
Zip:
Phone: (?.,63)
Fax: ��s) t5��,.J.,
Email: e V, e�6 , -co M
Name`
Address: 11+10 1�&rV1 e;rt _ PnW C-LD
City/State: J+L(:Cil40Vd0, WP%
Zip: of +_t 1
FPhoax:
ax5�-�-�
Ala
Email: e-P.Q �V1 @• `Jri-}EOM.
Signature:
Bulletin #003 —August 18, 2004
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