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Complete Application - Final Permit For WP Fire Rings
•l k PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547,Anacortes, WA 98221 Office Location: 904 6th Street,Anacortes WA 98821 Phone: `,71/ (360)299-1984 MASTER LAND USE PERMIT APPLICATION TYPE OF APPLICATION (check all that apply): ❑ Binding Site Plan (Preliminary)** ❑ Eligible Facility Request** 0 Shoreline Variance** ❑ Boundary Line Adjustment (BLA)** 0 Essential Public Facility 0 Short Plat (Preliminary)** ❑ BLA: Lot Consolidation** 0 Home Occupation Permit** 0 Site Plan Review** ❑ Conditional Use Permit (CUP) ** 0 Long Subdivision (Preliminary)** 0 Site-Specific Rezone Authorized by the Comprehensive Plan ❑ Critical Areas Exemption** ❑ Plat Amendment/Modification 0 Stormwater Management Manual 0 Critical Areas Permitted ❑❑ SEPA Environmental Review** Adjustments& Exceptions Alteration** 0 Shoreline Conditional Use ❑ Variance ** 0 Critical Areas Reasonable Use Permit** Exception/Variance** 0 Wireless Conditional Use Permit 151 Shoreline Exemption** 0 Cottage Housing Development** 0 Shoreline Substantial (WCUP)** Development Permit** ❑ 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: ram° 300 S v N SE j Pt v HEN./ nl A N I\c:-cD t 5\ v,/ `1?j 2-2-1 PARCEL NUMBER(S): SECTION,TOWNSHIP, & RANGE P3 ( 557 ZI 3 5 0 ! LOT SQUARE FOOTAGE&ACREAGE: PROJECT VALUATION: c30o\c LEGAL DESCRIPTION: PRESENT ZONING: �(z PL5, &c_.+. Z1 iowri 5 IJ, KO\n0e 1 E. PRESENT USE OF PROPERTY: CUT& FILL(CY) PROPOSED: (4 I N�, o ry .PPI2K 01-) Pi+5 Updated October 2021 Page 1 of 5 PRE-APPLICATION CONFERENCE HELD?: WATER SOURCE: I❑ Yes,the City file#is .3:1 No City of Anacortes 0 Private Well ❑ Community Well Master Land Use Permit Application SEWAGE DISPOSAL: ROAD ACCESS: JR' City of Anacortes 0 Septic T City Road 0 State Highway 0 Private Road CRITICAL AREAS OR BUFFERS ON SITE OR WITHIN 300 SHORELINES WITHIN 200 FEET: FEET: N Yes/Name: PU R-A- JOUrJ> 0 No O Yes* No ❑ Unknown! *If yes,please complete the Critical Area Identification Form FLOODPLAIN: Flood Zone: FIRM Panel# Date of Panel: LOT COVERAGE AREA CALCULATIONS: Existing Square Footage: j C1Z.� H. Proposed Square Footage: i QZ &/T IMPERVIOUS SURFACE AREA CALCULATIONS: (Existing Impervious Square Footage: New Impervious Surface: DESCRIPTION OF SUBJECT PROPOSAL: El Additional pages attached PROPOSED WORK: T+Fc vvo 044. 8EI ►v PQ-0(305p_c) I5 Ea _ P a-K C_Esv,(' rll�E \P- ?IT S t'NIITS1 N1Et"J PG 12-iN (75 es. N `L 1.0-w PVC UZ-E {�JTS AND wE 2E PLP\NNIN mac- Fji F ikt RJA/ S VSI N T 5��1� 1(- /� f�1 rifv4 7tiE AEAc • Pi) R-KK5 C1 W \ I\Li_ vs M I N i 4.&&C VAT -ctk14 our IKE 0I-9 )(2-'L 4-'►15 ivy U w►LL K GE P t u) A-r.r' ari hf2-P`'S Al ND 0 Fr-- -rtE .SEA-c 14 PROPERTY OWNER INFORMATION: Cl Multiple owners attached NAME: MAILING ADDRESS: C-A-N N P\C dv.=c-E 5 P d • 8o X 5�7 CITY,STATE,ZIP: PHONE#: AN P\Lo a--r--5, P\ cl 3 b o - z 9q -- 19 b� FAX#: EMAIL ADDRESS: n } C,o �.1 °� C i 0 c-'0,na,(J6-±-Q5, or }, I APPLICANT INFORMATION: a Same as property owner NAME: MAILING ADDRESS: Updated October 2021 Page 2 of 5 CITY,STATE,ZIP: PHONE#: FAX#: EMAIL ADDRESS: CONTACT PERSON: .] Same as property owner 0 Same as applicant NAME: MAILING ADDRESS: CITY,STATE,ZIP: PHONE#: FAX#: EMAIL ADDRESS: Master Land Use Permit Application ACKNOWLEDGEMENTS&SIGNATURE Read and initial each of the following statements prior to signing this application: I understand that land use and/or planning permits do not authorize earth disturbing activities, the removal of vegetation, or the construction of buildings. I understand that additional permits will be required after my land use and/or planning permitting process is completed. I understand that no earth disturbing activities (including the removal of vegetation) may take place until after my land use and/or planning process is complete, and only after I have received additional permits such as Fill &Grade, Building Permit, or Right-of-Way permit(s). I understand that if critical areas (wetlands, streams, steep slopes, etc.) are found on or near my N3-- property I am not authorized to impact these areas in any way and will be required to leave an undisturbed buffer area around the critical area, as determined according to the City's critical areas regulations. I understand that depending on the size and scope of my project, I may be required to provide N.3— maintenance and/or performance bonds for items such as landscaping, critical areas, public roads and/or public utilities that I construct or install. I understand that I am solely responsible for providing complete and accurate information to the City. I understand that if my application is missing information or if inaccurate materials are submitted, my N permits will be delayed. I understand that depending on how inaccurate and how incomplete my application is or becomes, the Department may require an entirely new application be submitted. I understand that when and if conditions change from that which my application originally represented, I am responsible for letting the City staff person assigned to my project know. • I understand that I am applying for permits from the City of Anacortes only; and that additional permits from other Federal, State,and Local agencies could be required. I understand that the City of Anacortes cannot advise me of permits that are required from other agencies, and that I must contact these agencies to make sure I comply with their requirements. These agencies include (but are not limited to): Corps of Engineers, Department of Natural Resources, Department of Fish &Wildlife, Department of Ecology, and Northwest Clean Air Agency. Updated October 2021 Page 3 of 5 I understand that I will be responsible for paying consultants that the City may deem necessary to /- review certain aspects of my application. I understand that these consultant reviews could include special inspections,traffic concurrency, critical areas, landscaping, stormwater, etc. Signature required on next page. Master Land Use Permit Application By affixing my signature hereto, I certify that I am the owner, or am acting as the Owner's authorized agent*, and that the application and documents contained with this submittal are complete and accurate to the best of my knowledge and abilities. If your title report lists a company, partnership or other owners, you must submit evidence that you are authorized to sign on behalf of the entity or others that are listed. Please attach additional signature sheets if there is more than one owner. Under penalty of perjury, I certify that the information, statements, answers above regarding the subject application(s) are true and correct to the best of my knowledge and belief. Property Owner Signature: 1 ``I , Printed Name: 1\/ Co 0-(54-iv,i S-r a NI Date: Z Zz- 262.Z Authorized Agent Signature*: Printed Name: Date: Updated October 2021 Page 4 of 5 Project Narrative- New Fire Rings at Washington Park The proposed work that the Park crew would like to do is to replace the existing five fire pits that are located along Sunset Beach with eight new fire rings.The Parks crew will use the mini excavator to remove the existing fire pits and will do this work without going onto the beach. The project time frame is to replace the fire pits before June 2022 so that the new fire rings can be enjoyed during our busy season at Washington Park. Proposed cut and fill volumes will be low. We are removing the current concrete fire pits and replacing them with steel fire rings. Location of critical areas on the subject property or within 300ft is the new fire rings will go in the same area of the existing fire pits that are located within 200ft of the Puget Sound shoreline. Parks crew will keep all equipment on the grass and off of the beach away from the shoreline. • - _L.' — . ( c-)tuN_ _ Fir2- . ./ 'P pi...)0_1_0 u-F, E A i•s-h-NI(7 \-) -•1 - . , ' ' f-1: ',%•-•:'-, ' ' '' - ''1 ' Ar- '.e,',,s• _ •' :' .•"'.,:'.4' :,-;;1 ' '• . -V'' ' '. .';; '1.0..4,elf:G'i.'-',:'41-i.41C.XS' 41;14;.,''. it' stll, li 4 4: ;•.., , , . ., . 4.) ' '' ''. .:' : :A. 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