Complete Application - PROP_20 JKL SSDP App

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Master Land Use Permit Application Updated October 2021 Page 1 of 4 PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 Phone: (360) 299-1984 MASTER LAND USE PERMIT APPLICATION TYPE OF APPLICATION (check all that apply): Binding Site Plan (Preliminary)** Boundary Line Adjustment (BLA)** BLA: Lot Consolidation** Conditional Use Permit (CUP) ** Critical Areas Exemption** Critical Areas Permitted Alteration** Critical Areas Reasonable Use Exception/Variance** Cottage Housing Development** Eligible Facility Request** Essential Public Facility Home Occupation Permit** Long Subdivision (Preliminary)**  Plat Amendment /Modification SEPA Environmental Review** Shoreline Conditional Use Permit** Shoreline Exemption** Shoreline Substantial Development Permit** Shoreline Variance** Short Plat (Preliminary)** Site Plan Review ** Site-Specific Rezone Authorized by the Comprehensive Plan Stormwater Management Manual Adjustments & Exceptions Variance ** Wireless Conditional Use Permit (WCUP)** Wireless Service Facility (WSF) Permit** **Permit type has supplemental checklist that must be submitted with Master Land Use Permit Application PROJECT & SITE INFORMATION: SITE ADDRESS: PROJECT NAME: PARCEL NUMBER(S): SECTION, TOWNSHIP, & RANGE LOT SQUARE FOOTAGE & ACREAGE: PROJECT VALUATION: LEGAL DESCRIPTION: PRESENT ZONING: PRESENT USE OF PROPERTY: CUT & FILL (CY) PROPOSED: PRE-APPLICATION CONFERENCE HELD?: Yes, the City file # is________________No WATER SOURCE: City of Anacortes  Private Well  Community Well