HomeMy WebLinkAboutPermit 84-26-SS - DERYCKE - SHORT PLAT84-26-ss
14704 58th avenue south
DERYCKE SHORT PLAT
SHORT PLAT NO. E54-Z(..-5
TUKWILA, WASHINGTON.
This space reserved for
recorder's use
Filed for' record at the
request of:
Name
Return to:
Planning Division
Office of Community Development
6230 Southcenter Boulevard
Tukwila,,.Washington 98188
Reviewed * and approved,by the Sho t
Subdivision Committee and hereby
certified for filing this AS
day of 19 r
Chairman,, 15c r Subdivision Comm t
:GAL DESCRIPTION
ORIGINAL: That portion of the Northwest 1/4 of Section. 23, Township 23 North, Range 3 Eas
Willamette Meridian; described as follows:
Lot 19 of the Plat of Tri -Vista Terrace, as recorded in Volume 53, Page 28, of Plats,
Records of King County, Washington. •
NEW -- Lot 1: The west 92.61 feet of Lot 19, Plat of Tri -Vista Terrace, as recorded
Volume 53, Page 28 of Plats, Records of King County, Washington.
Lot 2: The east 88.00 feet of Lot 19, Plat of Tri -Vista Terrace, as recorded
Volume 53, Page 28 of Plats, Records of King County, Washington. .Subject o
a Sanitary Sewer easement to the City of Tukwila across the east 10 feet if
described Lot 2. Said easement is for construction, operation and maintenan e
purposes.
DEPARTAlENT OF ASSESSMENTS
EXAMINED. AND APPROVED THIS
Day of , 19
ASSESSOR
DEPUTY ASSESSOR
APPROVAL
. )
I Si
J
25
0
tai
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25
25
25
0
Certificate No.
Short Plat No.
0
Land Surveyor's Certificate:
N 89 01' 3
S0• 1471
jlAla- ):49 aarsAr
Date
0 - FOUND MON IN CASE
S - SET 5/8" R/B a Y.P.C.
This short plat correctly represents a
survey made by me or under my direction
in conformance with the requirements of
appropriate state statute and has been
properly staked in .accordance with the
Tukwila Subdivision Code.
N
1), 309.63(P.)
Stamp
0
Map on File in Vault
Direction:
Scale:
20
'20
20
20
SCALES I = 50'
Page 2 of
.:LLc%rtm l lull :
•
;now all men by these pr(ents that we, the under jned, owner(s) in fee
simple and contract purchaser(s) of the land herein described do hereby
make a short subdivision thereof pursuant to RCW 58.17.060 and acknowledge
that said short subdivision shall not be further divided in any manner
within a period of five years, from date of record, without the filing of
a final plat. The undersigned further declare this short plat to be the
graphic representation of said short subdivision and that same is made
with the free consent and in accordance with the desire of the owner(s).
In witness whereof we have set our hands and seals. '
Name
Name Name
Name - Name
STATE OF WASHINGTON,
County of 4-1.f1
On this day personally appeared before me INLAND . c).E .
to me known to be the individual described in and who executed the with-
in and foregoing instrument, and acknowledged that A!4.14a, signed the
same as hLA free and voluntary act and deed, for th uses and pur-
poses therein mentioned.
GIVEN under my hand and official seal this (l'' day of Ja.t`SL
Name
Not Public in and for State of Washington,
resa ing at
TV Lot k
STATE .OF WASHINGTON,
County of .
On this day personally appeared before me
to me known to be the individual described in and who executed the with-
in and foregoing instrument, and acknowledged that signed the
same as free and voluntary act and deed, for the uses and pur-
poses therein mentioned.
GIVEN under my hand and official seal this day of
seal
Short Plat Number
Page • 3 of 3.
, 198
, '19
Notary Public in and for the State of Washington,
residing at
::
A
1908
4 s ue , City of Tukwila •
6200 Southcenter Boulevard
Tukwila Washington 98188
July 30, 1984
MRS. JOYCE BISTLINE
14709 58th Ave. S.
Tukwila,.WA 98188
RE: Short Plat 84 -26 -SS
Dear Mrs. Bistline:
Gary L VanDusen, Mayor
This letter is formal notification that on July 26, 1984 this short
plat was approved subject to submission of legal descriptions for the
lots including easements.
As soon as this document is given to us we will finish . processing. the
'short plat. I will call Mr. Arnett when it is ready for filing with
King County.
Respec ul
R ick Beeler
Associate Planner
RB /blk
cc: Al Arnett, Arnett & Associates
Brad Collins, Planning Director
1908
� *IIL A 4
y, City of Tukwila
O Z 6200 Southcenter Boulevard
� 2 0 Tukwila Washington 98188
Gary L VanDusen, Mayor
MEMORANDUM
TO: SHORT SUBDIVISION COMMITTEE MEMBERS
FROM: Planning Department StaffL15 ---
DATE: July 20, 1984
SUBJECT: Meeting of July 26, 1984
The Committee will meet next Thursday, July 28, 1984, at 1:30 p.m.
in the City Conference Room W3 to discuss the following application:
Application 84- 26 -SS: Gladys DeRycke Short Plat
The applicant proposes to divide at 16,844 square foot property into
two lots. Lot 1 contains a residence at 14702 58th Ave. S. and is
proposed to consist of 8,594 square feet. Lot 2 is undeveloped and is
to be 8,254 square feet in area. The property lies at the southeast
corner of 58th Ave. S. and S. 147th St. and is zoned R- 1 -7.2.
Compliance' with Zoning Code regulations exists except for the current
nonconforming side yard setback and 'residence along S. 147th St.
Instead of the required 15 -foot setback, the residence is set back only
10 feet. However, this issue does not effect the subject application.
A 6" water line is located in S. 147th St., and a 10" line exists in
58th Ave. S. Sewer lines exist in both streets per LID No. 5. Storm
drainage facilities (pipes) are located in both streets as well. A
' street light exists at the intersection of these streets. A fire
hydrant is located at the northeast corner of the intersection.
The proposal, conforms to the requirements of Section 17.08.070,
Tukwila Municipal Code, and the Planning Department recommends approval.
RB /blk
oes4.t- 94-11
I' VeiE e 7 "
JU! 2 1984
PUBLIC WORKS DEPT.
MASTER LAND
CITY OF TUIVILA
Central Permit System
DEVELOPMENT APPLICATION FORM
PLEASE WRITE LEGIBLY OR TYPE ALL REQUESTED INFORMATION -- INCOMPLETE APPLICATIONS WILL NOT BE
ACCEPTED FOR PROCESSING.
'/7- Z 7es
SECTION I:
TYPE OF APPLICATION: D BSIP
2)
GENERAL DATA
II SMORT
PLAT
SD CONDITIONAL
USE
SUED I V I S I O N
3) PROJECT LOCATION: (STREET ADDRESS, GEOGRAPHIC, LOT /BLOCK)
(/1/702 .58z S.) LoT /9 of T -/ - V/57 - 4 T£RR4c.
D SMORELINE
PERMIT
PRD DPMUD:
BAR
INTERURBAN
D UN USE SS. O VARIANCE U ZON 1 NG DAMENDMENT
/^ L'7�t -C PA? "NTG,��/V iz s. joIGE /3 /STL /NG _4 Pi" /
APPL I CANT : NAME V ,D Y DE R yCK E TELEPHONE ( ) 24 ` 5Z '.59
ADDRESS /4'702 58 -- 4/ ./.4 7 1/E. c$Q. Z1P
PROP. OWNER: NAME (-5 4 S 4PPL /C4 A/T) TELEPHONE ( )
ADDRESS
ZIP
SECTION II: 'PROJECT INFORMATION
DESCRIBE BR 1 EFLY THE PROJECT YOU. 'PROPOSE P ''dP & -sE . . T D._ D/I/ /DE LOT /9 /4/70
ZoT i /TH &/sT /41/6 //ovsE 04/ it/ELS - r
ANTICIPATED PERIOD OF CONSTRUCTION: FROM
WILL PROJECT BE DEVELOPED.IN PHASES? - OYES ONO
PROJECT STATISTICS:
A)
B)
C) SITE UTILIZATION:
R
IDING AT
ACREAGE OF PROJECT SITE:
FLOORS OF CONSTRUCTION:
ZONING DESIGNATION
COMP. PLAN DESIGNATION
BUILDING FOOTPRINT AREA
LANDSCAPE AREA
PAVING AREA
TOTAL PARKING STALLS :(Z,
-STANDARD SIZE.
- COMPACT SIZE
- HANDICAPPED SIZE
SECTION III: APPLICANT'S AFF I Dg
/ 7 '
SUBSCRIBED AND SWORN BEFORE ME
THIS t � k DAY OF C�Q
•
T Y FUELIC N AND F9R
( a
NET /- 90 2 Sr /. GROSS
TOTAL fI FLOORS
TOTAL GROSS
FLOOR AREA
FIE STATE OF WASHINGTON
TO
IF YES, DESCRIBE:
❑ O
❑ ❑
TOTAL LOADING SPACES /� A/4
AVER. SLOPE OF PARKING AREA T /
AVER. SLOPE OF SITE
ALL RESPECTS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
X DATE ` // }T e5/ x 74/
/ sefteASTr.MENTS
I NCLUDES : D BASEMENT D MEZZAN I NE
I NCLUDES: 0 BASEMENT 0 MEZZAN I NE
EXISTING "PROPOSED NOTES
,e /- -77cc R / -?Zav
Low Uc /vs/ 7J s /pe
• .233/ ❑/ ❑
IS THIS SITE DESIGNATED FOR SPECIAL CONSIDERATION ON THE CITY'S ENVIRONMENTAL BASE
MAP D Y ES ►i1 NO
BE(NG DULY SWORN, DECLARE THAT I AM THE
CONTRACT OR OWNER bF THE PROPERTY INVOLVED IN THIS APPLICATION AND THAT THE FORE-
GOING STATEMENTS AND ANSWERS HEREIN CONTAINED AND THE INFORMATION HEREWITH SUBMITTED ARE IN
AND BELIEF.
r
9 se .�7/
'V ' w43
' (SIGNATURE/ OF CONTRACT PURCHASER OR OWNER)
no
0
V
This space reserved for
recorder's use •
Filed for record at the
request of:
Name
Return to:
SHUK 1 h'LA I
C
TUKWI LA, WASHINGTON
Planning Division
Office of Community Development
6230 Southcenter Boulevard
Tukwila, .Washington 98188
Reviewed and approved by the Short
Subdivision Committee and hereby
certified for filing this
day, of 19
Chairman, Short Subdivision Committ
EGAL DESCRIPTION
• LOWED /./ TI/E 4/CRT / /WE5r % OF .SEC7 f3 %w4syip 2346e7
'44'6E 3 E9sr h/ /LCq/IE/7C / I>E`sc ,BED 45 'r55LLows: . •
LOT /9 . of 7 RAT OF / - 057 7Z - gR9cE) 95
RECORDED i,q J/OL04/E 53 04/ P46 ?8 ) of 71/E 80o1? of P2.47:5, s,
/N /4YG COUNT y l 09
DEPARTMENT OF ASSESSMENTS
EXAMINED AND APPROVED IRIS
Day of , 19
ASSESSOR
DEPUTY ASSESSOR
APPROVAL
..r:n 1 1)1 %
:now all men by these p1,:sents that we, the undekrgned, owner(s) in fee
simple and contract purchaser(s) of the land herein described do hereby
make a short subdivision thereof pursuant to RCW 58.17.060 and acknowledge
that said short subdivision shall not be further divided in any manner
within a period of five years, from date of record, without the filing of
a final plat. The undersigned further declare this short plat to be the
graphic representation of said short subdivision and that same is made
with the free consent and in accordance with the desire of the owner(s).
In witness whereof we have set our hands and seals.
Name Name
Name Name
Name Name
STATE OF WASHINGTON,
County of
. On this day personally appeared before meJCO (•E. jaD
to me known to be the individual described.in and who executed the with-
in and foregoing.instrument, and acknowledged thatiNI1u4 E signed the
same as. free and voluntary act and deed, for th uses and pur-
poses therein mentioned.
GIVEN under my hand and official seal this (tt' day of JLkZ\... , l9 &- .
seal
Notr Public 4n and f
ress•ing at
Tub Toklot l«
STATE .OF WASHINGTON,
County of
On this day personally appeared before me
e State of Washington,
to me known to be individual described in and who executed the with-
in and foregoing instrument, and acknowledged that signed the
sate as free and voluntary act and deed, for the uses and pur-
noses therein mentioned.
GIVEN under my hand and official seal this day of
seal
, '19
Notary Public in and for the State of Washington,
residing at
Sh;,rL Plat Number Page of
C) r
7
S
Land Surveyor's Certificate:
Certificate No.
25
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25
25
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Short Plat No.
O
N
N 89 Ol 38'
/07692
SO. 147TH ST
• NRO- (ll -i/i W •
Q - FOUND MON IN CASE
- SET 5/8" R/8 H Y.P.C.
This short plat correctly represents a
survey made by me or under my direction
in conformance With the requirements of
appropriate state statute and has been
properly staked in .accordance with the
Tukwila Subdivision Code.
Z/Ar aeZr77(cel
Date
O
309.63(P.) N
Stamp
20
20
NORTH
SCALE I = 50'
Map on File in Vault
Direction:
Scale:
Page
of
20
20
92.61
-
1
i
,
a M ire i sle 0 10 N
r 23.8
10
0,
LOT 2
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88.00
92.61
N88 -25-26 W ;
R ERAR SET W/ YPC (TYP)
D
•
180.61 (182.00 R)
I
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DIRT ROAD'"
C) r
7
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Land Surveyor's Certificate:
Certificate No.
25
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25
25
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25
Short Plat No.
O
N
N 89 Ol 38'
/07692
SO. 147TH ST
• NRO- (ll -i/i W •
Q - FOUND MON IN CASE
- SET 5/8" R/8 H Y.P.C.
This short plat correctly represents a
survey made by me or under my direction
in conformance With the requirements of
appropriate state statute and has been
properly staked in .accordance with the
Tukwila Subdivision Code.
Z/Ar aeZr77(cel
Date
O
309.63(P.) N
Stamp
20
20
NORTH
SCALE I = 50'
Map on File in Vault
Direction:
Scale:
Page
of
20
20
MASTER
PLEASE WRITE
ACCEPTED FOR
SECTION 1:
TYPE OF
)
APPLICANT:
CITY OF TU K1 "ILA
Central Permit System
LAND DEVELOPMENT APPLICATION FORM
LEGIBLY OR TYPE ALL REQUESTED INFORMATION -- INCOMPLETE APPLICATIONS W1 NOT BE e
gz. ,L? NC7 T -,4 ,v&"TT /Is$oCS
cc�� 7 V7- Z 7es
PROCESSING.
GENERAL DATA
APPLICATION: D ESIP
ADDRESS /`f7
PROP. OWNER: NAME (S4/YE 4 5 4PPL /C4 /T 1 J TELEPHONE ( )
ADDRESS /// ZIP
PROJECT LOCATION: (STREET ADDRESS, GEOGRAPHIC, LOT /BLOCK)
(/i7�2 ,SB 4yE S.) L d7 /9 07 7f/ - I" /$T4 TERR4C
SECTION II: PROJECT INFORMATI
DESCRIBE BRIEFLY THE PROJECT YOU :PROPOSE. I ?dP 5E... ! O . D /v_ /DL LoT /9 X4'7
TWO .LTS /(//7/ nxvSTi4/G /yorrsE 04/ '!/ES Lc7
ANTICIPATED PERIOD OF CONSTRUCTION: FROM
WILL PROJECT BE DEVELOPED . I N PHASES? n YES D NO I F YES, DESCRIBE:
PROJECT STATISTICS: ` n_ / n /
A) ACREAGE OF PROJECT S I TE : NET // 4 9 se..Tf GROSS /68 T �/ T S -e• %%EASEMENTS 99 7 S..T T
B) FLOORS OF CONSTRUCTION:
C) SITE UTILIZATION:
I
ZONING DESIGNATION
COMP. PLAN DESIGNATION
BUILDING FOOTPRINT AREA
LANDSCAPE AREA
PAVING AREA
TOTAL PARKING STALLS. :(Z,)
- STANDARD SIZE.
- COMPACT SIZE
- HANDICAPPED SIZE
TOTAL LOADING SPACES /V/ /st
AVER. SLOPE OF PARKING AREA
AVER. SLOPE OF SITE
THIS SITE DESIGNATED FOR SPECIAL CONSIDERATION
MAP ? DYES 1ST NO
D CONDUSEONAL DUNUSESS. D VARIANCE D ZONING
t 12, 9 U< c,�� 7e s . Jcy S T /N z
,4,D ys D E " I
4 7z
L p 1 �
NAME G / , EP s
TELEPHONE ( ) 1 /Z ` p� Z p
SECTION III: APPL I CAIyT' S AFF I DA.V 7
/ 71
-4'' -H BE,NG DULY SWORN, DECLARE THAT I AM THE
CONTRACT PURCHASER OR OWNER OF THE PROP TY INVOLVED IN THIS APPLICATION AND THAT THE FORE-
GOING 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.
4,y1„.¢,.. ' � DATE J / )? P�/ x �Q/ �;k
(S 1 �TURE/ OF CONTRACT PURCHASER OR OWNER)
SUBSCRIBED AND SWORN BEFORE ME
THIS ` k DAY OF
Y PUBLIC iN AND FI
!DING AT
1I SMORT
PLAT
0 SUBDIVISION
TOTAL I'I FLOORS
TOTAL GROSS
FLOOR AREA
. Z33/ ❑/
❑
19 e3
STATE OF WASHINGTON
5
/0570
(t /s -ny
it1-20
D SMORELI NE
PERMIT
❑ ❑
TO
❑
INCLUDES:
INCLUDES:
ON THE CITY'S
0 PRO OPMUD: � INTERURHAN
COMP.' PLAN
AMENDMENT
ZIP
D BASEMENT D MEZZAN I NE
D BASEMENT D ME ZZAN I NE
EXISTING PROPOSED NOTES
1/ -77c4 R-/
Low DENS / 77 , S /t711 ,01(
ENVIRONMENTAL BASE
i
LA- \
This space reserved•for
recorder's use
Name
Return to:
brlutt rLA I Nu
Filed for record at the
request of: •
TUKWILA, WASHINGTON
Planning Division
Office of Community Development
6230 Southcenter Boulevard
TukwilaWashington 98188
Reviewed and approved by the Short
Subdivision Committee and hereby
certified for filing_ this
day, of
DEPARTMENT OF ASSESSMENTS
EXAMINED AND APPROVED TaIS'
Day of , 19
EGAL DESCRIPTION
• LocgTE /N T-/E . 4/ORT //if/£5T % OF SE z3 J Tojysy/p 234/0R7
7?94(6C 3 EIsT � /LL4/J£TE If Egv/44/ 15ESCI?/BED 45 'f L.L OWS;
LOT /9 • of TI/E P2-4T OF 7 / - J 7 PR 9CE 9S
RECORDED /' l/oZ/ME 53 04/ a6E 28 ac 7'E 8 of or PL42 >
� J
/4/ /' / '/G Coo 'vTy Gt/4sy /N6TOAJ
ASSESSOR
Chairman, Short Subdivision Committ
DEPUTY ASSESSOR
APPROVAL
19
h 1 1 I-
;;rldow,'al l: men by these p ,-tents that we, the under ..ryned, owner(s) in fee
simple and contract purchaser(s) of the land herein described do hereby
make a short subdivision thereof pursuant to RCW 58.17.060 and acknowledge
that said short subdivision shall not be further divided in any manner
within a period of five years, from date of record, without the filing of
a final plat. The undersigned further declare this short plat to be the
graphic representation of said short subdivision and that same is made
with the free consent and in accordance with the desire of the owner(s).
In witness whereof we have set our hands, and seals.
Name Name
Name Name
Name Name
STATE OF WASHINGTON,
County of' L1
. On this day personally appeared before me
to me known to be the individual described.in and who executed the with-
in and foregoing instrument, and acknowledged that �A,� signed the
same as free and voluntary act and deed, for th uses and pur-
poses therein mentioned.
GIVEN under my ' (t d a y of JAAJL , 19 e
a/inkki
Not Public in and f the State of Washington,
residing at
seal
seal
Tt3Lu►
STATE .OF WASHINGTON,
County of
On this day personally appeared before me
to me known to be individual described in and who executed the with-
in and foregoing instrument, and acknowledged that signed the
same as free and voluntary act and deed, for the uses and pur-
poses therein mentioned.
GIVEN under my hand and official seal this day of
1'ota'ry Public in and for the State of Washington,
residing at
Shcrt Plat Number Pace of
VIII v.. v. wv ♦♦ r
r
92.61
.
3„4£,4£010 N
1° 23.1
cor, ,
,
( TO BE DEDICATED TO
10' SANITARY SEWER E
C) r
J
25
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25
25
25
s
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°
Certificate No.
Short Plat No.
N 89° 01'. 38
SO. 147TH
• wI rw.rn.
0
309.63 (P.)
Land Surveyor's Certificate:
This short plat correctly represents a
survey made by me or under my direction
in conformance with the requirements of
appropriate state statute and has been
properly staked in .accordance with the
Tukwila Subdivision Code.
Z1/6 / / ,9 8 f agre-tV7
Date
- FOUND MON IN CASE
19 - SET 5/8" R/8 A .Y.P.C:" ' • v�`�1
201 114" � LE' " =50' td
otoPt
/
Stamp
Map on File in Vault
Direction:
Scale:
•
Page of
Transamerica
Title Services (
Arnett and Associates
1811 125th S.E.
Bellevue, WA 98005
ATTN: Al Arnett
GRANTEE:
PURPOSE:
AREA AFFECTED:
RECORDING NO.:
Transamerica
Title Insurance Company'
10835 Northeast Eighth
Box 1493
Bellevue, Washington 98009
(208) 451-7301
SHORT PLAT CERTIFICATE
Deposit:
Tax:
Total:
...... _...�.. .. . _..,,...r ..................n. v.y,mc. r i nv�.F :,..CJl1'A:'A�:17:
Order No. 906114
Certificate for Filing
Proposed Short Plat
In the matter of the plat to be submitted to King County for approval,
this Company has examined the records of the King County Auditors
and Clerks offices, and the records of the Clerk of the United States
District Court holding terms in said County, and from such examination
hereby certifies the title to the following described land, in said
King County, to wit:
Lot 19 of Tri -Vista Terrace, as per plat recorded in Volume 53 of
Plats, on page 28, records of King County;
Situate in the County of King, State of Washington.
VESTED IN:
GLADYS DeRYCKE, as her separate estate;
EXCEPTIONS:
A. General taxes, as follows, together with interest and penalty, if
any, after delinquency:
Tax Account No. Year Amount Billed Amount Paid Princicpal Balance
868780- 0095 -02 Igig $883.76 $441.88 $441.88
The levy code for the property herein described is 2380 for 1984.
1. EASEMENT AND THE TERMS AND CONDITIONS THEREOF:
City of Tukwila, a municipal corporation
Slopes
Northerly portion of property herein
described
6708043
Together with a temporary construction easement
4 feet of the property herein described.
2. Restrictive covenants, easements, and slope rights, as
the plat of Tri- Vista - Terrace.
- continued-
$100.00
8.10
across the Northerly
disclosed by
$44.."1,
3. MORTGAGE AND THE
MORTGAGOR:
MORTGAGEE:
LOAN NO.:
BRANCH:
ADDRESS:
ORIGINAL AMOUNT:
DATED:
RECORDED:
RECORDING NO.:
ASSIGNMENT OF SAID
ASSIGNEE:
DATED:
RECORDED:
RECORDING NO.:
MORTGAGE:
Page 2
TERMS AND CONDITIONS THEREOF:
Continental Illinois National Bank and
Trust Company of. Chicago
August 1, 1962
August 3, 1962
5461296
Wilber R. Scholes and Betty J. Scholes, husband
and wife
Northwest Mortgage, Inc., a corporation
Not disclosed
Not disclosed
Not disclosed
$20,000.00
June 12, 1962
June 20, 1962
5442397
END OF EXCEPTIONS
Records examined to June 8, 1984 at 8:00 A.M.
TRANSAMERICA TITLE INSURANCE CO.
JR:tm
Order No. 906114
Form No. W- AK•555.1
(Previous Form No. nn SP)
•
Desire by
To assist in locating the premises. It ii not based on a survey, and the company
assumes no liability for variations if any, in dimensions and location.
! 42 0
or
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CC P
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Checked
SKETCH OF PROPERTY SE OUT IN ATTACHED ORDER
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s ue
710 asto477 -
5 / rh ST
Phis Vo6 �.- C PC. oZg order No, 9
/et. OF
/9
4.437
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20
21
6-f 22
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23
24
25
00 9 5
0 10 5
0
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.43- . .9 ' i . 5 1 1 1 is
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Note —This map does not purport to show all highways, roads or easements affecting the property.
r ^xre.•; +cfs. ::enrt!va :ts;,la�nxcr:•trrat. ene- .�,vmr
CITY OF TUIJILA
Central Permit System
MASTER LAND DEVELOPMENT APPLICATION FORM
PLEASE WRITE LEGIBLY OR TYPE ALL REQUESTED
ACCEPTED FOR PROCESSING.
SECTION II: PROJECT INFORMATION
PROJECT STATISTICS:
A)
B)
C ).
IS
ACREAGE OF PROJECT SITE:
FLOORS OF CONSTRUCTION:
SITE UTILIZATION:
ZONING DESIGNATION
COMP. PLAN DESIGNATION
BUILDING FOOTPRINT AREA
LANDSCAPE AREA
PAVING AREA
TOTAL PARKING STALLS:(z)
- STANDARD SIZE.
MAP? OYES KNO
SUBSCRIBED AND SWORN BEFORE ME
THIS I I 141 DAY OF c.f 1
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INFORMATION - - INCOMPLETE APPLICATIONS WILL BE r
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SECTION 1: GENERAL DATA
TYPE OF APPLICATION: O Bs 1 P
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3) PROJECT LOCATION: (STREET ADDRESS, GEOGRAPHIC, LOT /BLOCK)
(/t7�2 ,58 4PES.) LaT /9 of Tif/ -14574 TEAR/4c
APPL I CANT : NAME V LAD yS JE YCK E C TELEPHONE (
ADDRESS /7 70 Z 5p 7 -,4 2 e6, d O ,
PROP. OWNER: NAME (_ -4 S //PPL /C4/Vr) TELEPHONE (
ADDRESS
/B// /25 IL , 6e2141441.
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DESCRIBE BRIEFLY THE PROJECT YOU PROPOSE. P'd /' o.SE.. TO _ .D /I/ /DE L oT /9 /4/76
71u/ ,LT Gt/. /TH & /5774/6 I/00SE 04/ h1/E57` LOT'
ANTICIPATED PERIOD OF CONSTRUCTION: FROM TO
WILL PROJECT BE DEVELOPED , I N PHASES? OYES ONO I F YES, DESCRIBE:
THIS SITE DESIGNATED FOR SPECIAL CONSIDERATION ON
NET 4 GROSS /v8""S� fZEASEMENTS 9 Se .TT
TOTAL Il FLOORS
TOTAL GROSS
FLOOR AREA
EXISTING PROPOSED
LLCU rEws/ 77 DS /P isW,/1
• 2...33 DI ❑
- COMPACT SIZE
- HANDICAPPED SIZE ���
TOTAL LOADING SPACES /V /f� AIA
AVER. SLOPE OF PARKING AREA !/
AVER. SLOPE OF SITE
X DATE / / )t Pi X
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INCLUDES:
INCLUDES:
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0 BASEMENT 0MEZZANINE
0 BASEMENT 0MEZZANINE
NOTES
THE CPTY'S ENVIRONMENTAL BASE
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• BE DULY SWORN, DECLARE THAT I AM THE
SECTION III: AAPPLII T'
CONTRACT RCHASER OF2 OWNER %F THE PROP - TY INVOLVED IN THIS APPLICATION AND THAT THE FORE-
GOING 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.