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•l k PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT <br /> Mailing Address: P.O. Box 547,Anacortes, WA 98221 <br /> Office Location: 904 6th Street,Anacortes WA 98821 Phone: <br /> `,71/ (360)299-1984 <br /> MASTER LAND USE PERMIT <br /> APPLICATION <br /> TYPE OF APPLICATION (check all that apply): <br /> ❑ Binding Site Plan (Preliminary)** ❑ Eligible Facility Request** 0 Shoreline Variance** <br /> ❑ Boundary Line Adjustment (BLA)** 0 Essential Public Facility 0 Short Plat (Preliminary)** <br /> ❑ BLA: Lot Consolidation** 0 Home Occupation Permit** 0 Site Plan Review** <br /> ❑ Conditional Use Permit (CUP) ** 0 Long Subdivision (Preliminary)** 0 Site-Specific Rezone Authorized by <br /> the Comprehensive Plan <br /> ❑ Critical Areas Exemption** ❑ Plat Amendment/Modification <br /> 0 Stormwater Management Manual <br /> 0 Critical Areas Permitted ❑❑ SEPA Environmental Review** Adjustments& Exceptions <br /> Alteration** 0 Shoreline Conditional Use <br /> ❑ Variance ** <br /> 0 Critical Areas Reasonable Use Permit** <br /> Exception/Variance** 0 Wireless Conditional Use Permit <br /> 151 Shoreline Exemption** <br /> 0 Cottage Housing Development** 0 Shoreline Substantial (WCUP)** <br /> Development Permit** ❑ Wireless Service Facility (WSF) <br /> Permit** <br /> **Permit type has supplemental checklist that must be submitted with Master Land Use Permit Application <br /> PROJECT& SITE INFORMATION: <br /> SITE ADDRESS: PROJECT NAME: <br /> ram° 300 S v N SE j Pt v HEN./ nl <br /> A N I\c:-cD t 5\ v,/ `1?j 2-2-1 <br /> PARCEL NUMBER(S): SECTION,TOWNSHIP, & RANGE <br /> P3 ( 557 ZI 3 5 0 ! <br /> LOT SQUARE FOOTAGE&ACREAGE: PROJECT VALUATION: <br /> c30o\c <br /> LEGAL DESCRIPTION: PRESENT ZONING: <br /> �(z PL5, &c_.+. Z1 iowri 5 IJ, KO\n0e 1 E. <br /> PRESENT USE OF PROPERTY: CUT& FILL(CY) PROPOSED: <br /> (4 I N�, o ry .PPI2K 01-) Pi+5 <br /> Updated October 2021 Page 1 of 5 <br />