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Master Land Use Permit Application <br />Updated October 2021 Page 2 of 4 <br />SEWAGE DISPOSAL: <br />City of Anacortes  Septic <br />ROAD ACCESS: <br />City Road  State Highway Private Road <br />CRITICAL AREAS OR BUFFERS ON SITE OR WITHIN 300 FEET: <br />Yes*No Unknown <br />*If yes, please complete the Critical Area Identification Form <br /> <br />SHORELINES WITHIN 200 FEET: <br />Yes / Name:_____________________________  No <br />FLOODPLAIN: <br />Flood Zone: FIRM Panel # Date of Panel: <br />LOT COVERAGE AREA CALCULATIONS: <br />Existing Square Footage: Proposed Square Footage: <br />IMPERVIOUS SURFACE AREA CALCULATIONS: <br />Existing Impervious Square Footage: New Impervious Surface: <br /> DESCRIPTION OF SUBJECT PROPOSAL: Additional pages attached <br />PROPOSED WORK: __ <br /> _________ <br /> _________ <br /> _________ <br /> _________ <br />_____________________________________________________________________________________________________ <br />_________________________________________________________________________________________________ <br />PROPERTY OWNER INFORMATION: Multiple owners attached <br />NAME: MAILING ADDRESS: <br />CITY, STATE, ZIP: PHONE #: <br />FAX #: EMAIL ADDRESS: <br />APPLICANT INFORMATION: Same as property owner <br />NAME: MAILING ADDRESS: <br />CITY, STATE, ZIP: PHONE #: <br />FAX #: EMAIL ADDRESS: <br />CONTACT PERSON: Same as property owner Same as applicant <br />NAME: MAILING ADDRESS: <br />CITY, STATE, ZIP: PHONE #: <br />FAX #: EMAIL ADDRESS: <br />Project in Fidalgo Bay <br />emergency repair of north breakwater piles. Please see the attached project narrative. <br />A 2020 biological evaluation is provided in lieu of a habitat assessment.