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Master Land Use Permit Application <br />Updated April 13, 2021 Page 1 of 4 <br />PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT <br />Mailing Address: P.O. Box 547, Anacortes, WA 98221 <br />Office Location: 904 6th Street, Anacortes WA 98821 <br />Phone: (360) 299-1984 <br /> Master Land Use Permit Application <br />TYPE OF APPLICATION (check all that apply): <br />¨ Administrative Interpretation <br />¨ Annexation Request <br />¨ Binding Site Plan (Preliminary) <br />¨ Boundary Line Adjustment (BLA)** <br />¨ BLA: Lot Consolidation** <br />¨ Comprehensive Plan/ Map <br /> Amendment Request** <br />¨ Conditional Use Permit (CUP) per AMC <br />19.36** <br />¨ Conditional/Special Use Permit (CUP) <br />per AMC 17.70** <br />¨ Cottage Housing Development** <br />¨ Development Agreement <br />¨ Essential Public Facility <br />¨ Floodplain Development Permit <br />¨ Home Occupation Permit** <br />¨ Long Subdivision (Preliminary)** <br />¨ Lot Certification <br />¨ Minor Permit Revision <br />¨ Plat Amendment /Modification <br />¨ SEPA Environmental Review** <br />¨ Shoreline Conditional Use Permit** <br />¨ Shoreline Exemption** <br />¨ Shoreline Substantial Development <br /> Permit** <br />¨ Shoreline Variance** <br />¨ Short Subdivision (Preliminary)** <br />¨ Site Plan Review – Type 1** <br />¨ Site Plan Review – Type 2** <br />¨ Stormwater Management Manual <br /> Adjustments & Exceptions <br />¨ Variance (Level 1) ** <br />¨ Variance (Level 2) ** <br />¨ Wireless Conditional Use Permit <br /> (WCUP)** <br />¨ Wireless Service Facility (WSF) <br /> Permit** <br />¨ Zoning Code/ Map Amendment <br /> Request (Rezone) <br />**Permit type has supplemental application/checklist that must be submitted with Master Land Use Permit Application <br /> PROJECT & SITE INFORMATION: <br />SITE ADDRESS:PROJECT NAME: <br />PARCEL NUMBER(S):SECTION, TOWNSHIP, & RANGE <br />LOT SQUARE FOOTAGE & ACREAGE:PROJECT VALUATION: <br />LEGAL DESCRIPTION:PRESENT ZONING: <br />PRESENT USE OF PROPERTY:CUT & FILL (CY) PROPOSED: <br />PRE-APPLICATION CONFERENCE HELD?: <br />¨ Yes, the City file # is________________ ¨ No <br />WATER SOURCE: <br />¨ City of Anacortes ¨ Private Well ¨ Community Well <br />SEWAGE DISPOSAL: <br />¨ City of Anacortes ¨ Septic <br />ROAD ACCESS: <br />¨ City Road ¨ State Highway ¨ Private Road