HomeMy WebLinkAbout101716_ca09k�¢sON c0 JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street, Port Townsend, WA 98368 1 Web: www.co.iefferson.wa.us/communitydevelopment
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1\0 Tel: 360.379.44501 Fax: 360.379.4451 1 Email: dcdOco.iefferson.wa.us
SquareONE Resource Center I Building Permits & Inspections I Development Review I Long Range Planning
Jefferson County
Board of County Commissioners
Consent Agenda Request
To: Board of County Commissioners
Philip Morley
Through: Patty Charnas, Director ;Cf
From: Michelle Farfan, Associate Planner `ft1�i
Date: Consent Agenda for October 17, 2016
Subject: Final Short Plat Approval for Dog Townsend Short Plat, MLA11-00040 / SUB11-00001
Statement of Issue: Final short plat approval of a two -lot short plat located off of South Discovery and
Timberline Roads, Port Townsend. Requesting final approval by the Board per JCC Section 18.35.200
and RCW 58.17.170. Applicant is Amanda Webby.
Analysis: Staff determined that the application as submitted on March 1, 2011 met said criteria of
Jefferson County Code (JCC) Section 18.35.100 in written Findings and Conclusions dated October 6,
2011 followed by a written approval with conditions. All conditions have been met and verified by each
department as verified by signing the survey mylar and copies. Written Findings and Conclusions are
required per RCW 58.17.195 which state in part that a county makes a formal written finding of fact that
the proposed subdivision or proposed short subdivision is in conformity with applicable zoning
ordinance or other land use controls which may exist.
Alternatives: The requested action is mandatory per RCW 58.17.170 and Jefferson County Code
Section 18.35.130(1)(c).
Fiscal Impact: There is no identifiable fiscal impact related to this request for final plat approval.
Applicant has paid 2016 full year property taxes in the amount of $3,297.94.
Recommendation: Per Jefferson County Ordinance and State Law, the department requests that the
Board grant final short plat approval and adopt the written findings and conclusions.
ReVI@W�S� py:
Philip Morley, Qount Administrator----_
JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
UNIFIED DEVELOPMENT CODE
TYPE I LAND USE PERMIT
APPLICANT: AMANDA WEBBY
10 TIMBERLINE DR
PORT TOWNSEND WA 983689089
DATE ISSUED: October 06, 2011
DATE EXPIRES: October 06, 2014
MLA NUMBER: MLA11-00040
PROJECT PLANNER: Michelle Farfan
PROJECT DESCRIPTION:
Proposed 2 -lot Short Plat consisting of approximately 11.65 acres. Lot 1 is approximately
5.40 -acres in size and Lot 2 is approximately 6.25 -acres in size. Both lots will have direct access off of Timberline
Road, a private road. Lot 2 has an existing on-site septic system and a single family residence. Lot 1 will be served by
a future on-site septic system and potable water is supplied to both lots via a two-party well located on Lot 1.
PROJECT LOCATION:
Parcel Number 001 203 010, Section 20, Township 30, Range 1W, WM, Located at 10 Timberline Road, Port
Townsend, WA 98368
CONDITIONS:
1.) DEPARTMENT OF PUBLIC WORKS:
All easements of record shall be graphically portrayed on the final plat with the Auditor's File Number (AFN) of
the easement(s) also referenced on the face of the plat.
2.) South Discovery Road and Timberline Road shall be graphically portrayed on the face of the final plat.
3.) The surveyor's note on Sheet 2 of the preliminary plat describes the status of Timberline Road. It does not state
whether there is a formal road maintenance agreement, but it does refer to the applicant's participation in road
maintenance expenses since purchasing the property in 2002. The issue of road maintenance should be
clarified on the final plat. If there is a road maintenance agreement for Timberline Road, it should be referenced
on the final plat. If there is a separate agreement that obligates the owners of the subject property to participate
in road maintenance, this agreement should also be referenced on the final plat. If potential purchasers should
expect to participate in road maintenance, this should be stated on the final plat. If there is not a road
maintenance agreement for Timberline Road, there should be a notice on the final plat to this effect.
4.) Address plates for the lots shall be located in accordance with the provisions of the Jefferson County 911
Emergency Locator System Ordinance.
5.) Addresses shall be assigned to all lots. Addresses may be shown on the final plat or may be applied for at the
time of building permit application.
6.) In accordance with the Jefferson County Fee Schedule Ordinance, the Public Works Department charges an
hourly fee for application and plan reviews, project inspections, meetings, hearings, and final review. The
proponent shall pay all fees incidental to the proposal prior to final approval. In the event that approval for the
proposal is denied by Jefferson County or the proponent does not complete the proposal, the proponent shall
still be responsible for paying the Department's fees. The Department's fee is currently $65 per hour.
7.) The proponent shall submit a blue line copy of the site plan and lot closure information prepared by a licensed
surveyor to the Department for review. The proponent shall make any corrections or additions prior to final
approval.
8.) After all preliminary plat conditions are met; the proponent shall submit a final mylar of the plat to the
Department for approval by the Director of Public Works.
9.) HEALTH DEPARTMENT:
The location of the soil test pit and corresponding test pit number shall be graphically portrayed on the face of
the final plat.
10.) The septic system (SEP73-134) shown attached to the kennel has been fully abandoned. This needs to be
labeled on the face of the final plat as "SEP73-134 abandoned".
11.) Graphically portray the additional new septic tank for the kennel AND include approximate transport line to the
homes' septic tank.
12.) Remove the language "Septic Design in Progress" from the survey.
13.) All components of existing septic systems, including primary and reserve drainfields shall be graphically
portrayed and labeled with the county assigned septic permit number.
14.) Label the public water supply with the water system number #AC0093.
15.) Define the use of each well and add their applicable well tag numbers to the face of the final plat.
16.) Bob Leach, NTI, as a part of his water system design recommended that the owners develop an Agreement
between the two parcels regarding responsibility to maintain and operate the treatment system. The Agreement
needs to be submitted for review prior to recording. Once the agreement is recorded, it shall be referenced on
the face of the final plat.
17.) The following notice shall be placed on the face of the final plat under "Notice to Potential Purchasers"
The lots, parcels, or tracts contained within this subdivision were approved based on design standards and
regulatory requirements in effect at the time of final approval. Sewage disposal systems have not been
approved for the lots, parcels, or tracts contained within this subdivision. On-site sewage disposal systems shall
meet design standards and regulatory requirements in effect at the time of application for a sewage disposal
permit. Purchaser should contact the Jefferson County Health Department for procedures concerning permit
applications.
Any removal of or major disturbances of soil within the proposed drainfield areas may create site conditions that
are unacceptable for the installation of sewage disposal systems.
The 100 foot sanitary control area for the individual well shall be protected from potential source of
contamination, such as septic tanks and drainfields, sewer lines, underground storage tanks, roads, vehicles,
non-residential structures, barns, feed stations, grazing animals, enclosures for maintaining fowl or animal
manure, liquid or dry chemical storage, herbicides, insecticides, hazardous waste, or solid waste of any kind or
description.
18.) DEVELOPMENT REVIEW DIVISION:
Based on requirements of Chapter 18.35 JCC Final Short Plat, the final mylar shall be prepared in accordance
with the final short plat checklist. A copy of Chapter 18.35 JCC is attached.
19.) An accurate vicinity map shall be graphically portrayed on the face of the final plat.
20.) The final blue line shall depict the name of the subdivision and the county assigned number of
SUB 11-00001 /MLA 11-00040.
21.) The names and parcel numbers of adjacent owners shall be deleted from the final mylar survey.
22.) All components of existing septic systems, including primary and reserve drainfields shall be graphically
portrayed and labeled with the county assigned septic permit number.
23.) See "red -line" for additional corrections, additions, and deletions.
24.) The Deeds of Trust as identified in the plat certificate shall sign and approve the final mylar prior to final mylar
recording.
25.) An updated plat certificate or supplement shall be submitted with the final blueline and shall be 30 days current.
26.) Certificates for the Board of County Commissioners, Clerk of the Board, Director of the Department of Public
Works, Department of Community Development Administrator and Environmental Health Department need to
be added.
27.) Utilities and transportation facilities should be installed in the same rights-of-way when the effect will be to
reduce the adverse impacts on the physical environment.
28.) Arrangements shall be made by the applicant to install underground utility lines for electricity and telephone
service to all lots prior to final plat approval.
29.) The following notices shall be placed on the final plat under "Notice to Potential Purchasers":
Outdoor residential storage shall be maintained in an orderly manner and shall create no fire safety, health or
sanitary hazard.
Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring
dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards
specific to the district in which the storage is kept, and shall be in keeping with the character of the area.
Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor
vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or
salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet
the requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall
any such junk motor vehicles be stored in a critical area.
30.) The following notices shall be placed on the final plat under "Notice to Potential Purchasers":
Exterior lighting for residential uses shall not exceed twenty feet (20') in height from the finished grade excepting
when such lighting is an integral part of building or structure. Ground level lighting is encouraged.
Exterior lighting shall be energy efficient and shielded or recessed so that direct glare and reflections are
contained within the boundaries of the parcel.
Exterior lighting shall be directed downward and away from adjoining properties and public rights-of-way. No
lighting shall blink, flash, or be of unusually high intensity or brightness.
All lighting fixtures shall be appropriate in scale, intensity, and height to the use they are serving.
31.) The following notices shall be placed on the final plat under "Notice to Potential Purchasers":
Maximum building height shall not exceed 35 feet.
Maximum impervious surface coverage shall not exceed 25%.
Minimum setbacks from South Discovery Road and any ingress/egress easement right-of-way shall be 20 feet.
Minimum side yard setbacks shall be 5 feet.
32.) The following notices shall be placed on the final plat under "Notice to Potential Purchasers":
Any further subdivision of the lots within this plat will be subject to the densities permitted in the Jefferson
County Ordinances and Codes in effect at time of such application. These lots may or may not be further
subdivided in the future.
Approval of this subdivision does not constitute approval of building or sewage disposal permits on each lot.
Permit approval will be subject to building lot plans, type of use, contours, and soils on individual lots. Permits
will be reviewed in accordance with site conditions and regulations existing on the date the permits are applied
fo r.
Any removal of or major disturbance of soil within the proposed drainfield areas may create site conditions that
are unacceptable of the installation of sewage disposal systems.
33.) The applicant must submit a reproducible copy plus seven (7) paper copies of the proposed final short plat to
the Department of Community Development. The proposed final short shall contain elements as described in
Chapter 18.35.120 JCC and shall include certifications and other requirements as provided in Chapter
18.35.190 JCC and 18.35.370 JCC.
34.) The sale of lots prior to final short plat approval is unlawful.
35.) Preliminary approval will expire on October 6, 2014. The Department of Community Development shall not be
responsible for notifying the applicant of impending preliminary short plat expiration.
36.) It is the responsibility of the applicant or authorized representative to ensure the final short plat is submitted in
accordance with the conditions of preliminary approval. This includes paying all property taxes and submitting a
recording fee for the final plat and supply an updated plat certificate (within 30 days of submittal), all of which is
outlined in the final short plat checklist.
FINDINGS:
1.) The Administratorfinds that this application complies with applicable provisions of the Unified Development Code, all other
applicable ordinances and regulations, and is consistent with the Jefferson County Comprehensive Plan and Land Use map.
APPEALS:
Pursuant to RCW 36.70C, the applicant or any aggrieved party may appeal this final decision to Jefferson County Superior Court within
twenty-one (2 1) calendar days of the date of issuance of this land use decision. For more information related to judical appeals see JCC
18.40.340.
UDC Administrator
MLA11-00040
3 of 3
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SURVEY NOTES 24.66
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SURVEYS, PAGE 64, RECORDS OF JEFFERSON C
FINDINGS AND CONCLUSIONS FOR
ADMINISTRATIVE SUMMARY DECISION
Amanda Webby & Steve Lampert
DOG TOWNSEND SHORT PLAT; SUB 11-00040/MLA11-00040
Proposal: Subdivide 11.65 acres into 2 lots with a minimum lot size of 5.39 acres for
residential use. The property is zoned RR 1:5.
Property Location: The property is located at 10 Timberline Road, Port Townsend; at its
intersection South Discovery Road., on the east side of the road.
Legal Description: The portion of the South half of the Northeast quarter of the Southwest
quarter in Section 20, Township 30 North, Rage 1 West, WM. Lying East of
Chevy Chase Road, now know as South Discovery Road, Jefferson County,
Washington.
Property
Description: The northwest corner of the parcel is at an elevation of approximately 219
feet. The northeast corner's elevation is approximately 217 feet; the
southeast corner's elevation is approximately 222 feet and the southwest
corner is approximately 215 feet. The center of the parcel is at
approximately 218 feet in elevation. The parcel is heavily vegetated (except
where existing development has been constructed) with an existing mobile
home, a couple out buildings, and a dog kennel. South Discovery Road runs
parallel to the parcels western boundary and Timberline Road runs parallel
to the northern parcel boundary. Access to the lots is from a single access
off of South Discovery Road, known as Timberline Road. There are two
existing wells; one on Lot 1 and one on Lot 2. The well on Lot 1, is an
approved public water system.
Community Plan: The Jefferson County Comprehensive Plan Land Use Map designates the
site as Rural Residential 1:5.
Surrounding Area: The surrounding parcels range in size from about 2 acres to 40 acre parcels.
The majority of the surrounding parcels are approximately 5 acre tracts and
larger. Several of the surrounding parcels have existing houses and several
of the parcels are undeveloped. Access to surrounding parcels is via South
Discover Road, Timberline Road, and private easements.
Applicable Goals and Policies:
Jefferson County Comprehensive Plan
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 11-00040/SUB 11-00001
Page I of 17
Chapter 3, "Rural Residential Land Use Policies", pages 3-47 to 3-49.
Chapter 3, "Transportation Policies", page 3-61.
Chapter 3, "Rural Character Policies", 3-61 to 3-64.
Applicable Ordinances:
Ordinance No. 11-1218-00, Jefferson County Code (Title 18)
SEPA: The proposed short subdivision is categorically exempt from environmental review. (WAC
197- 11-800(6)(a).
Notice Information: Mailed to county agencies and adjacent property owners May 6, 2011.
Published in the May 11, 2011 edition of the Jefferson County -Port Townsend Leader. Applicant
posted site on May 11, 2011 per Affidavit of Posting Notice.
Testimony: No verbal or written testimony was received on this application.
Agency Responses:
• County Public Works Department: Written comments dated May 25, 2011 are hereby
incorporated by reference.
• County Health Department: Written comments dated July 27, 2011 are hereby
incorporated by reference.
• Jefferson County Assessor's Office: Written comments dated May 16, 2011, June 15,
2011 & June 24, 2011 are hereby incorporated by reference.
• East Jefferson Fire & Rescue: Written comments dated May 24, 2011 are hereby
incorporated by reference.
• Jefferson Transit: No comment received.
• Port of Port Townsend: No comment received.
• Port Gamble S'Klallam Tribe: No comment received.
• Jamestown S'Klallam Tribe: No comment received.
• Point No Point Treaty Council: No comment received.
• Port Townsend School District 50: No comment received.
• Skokomish Tribe: No comment received.
• Suquamish Tribe: No comment received.
Staff Findings and Conclusions:
1. The proposal is to subdivide 11.65 acres parcel into two (2) residential lots.
2. The proposed short subdivision is subject to the policies of the Jefferson County
Comprehensive Plan. The applicable policies are discussed below.
3. The proposed short subdivision is subject to the requirements of Chapters 18.30 and 18.35
of the Jefferson County Code (JCC). There are several ordinance requirements that apply to
the proposed subdivision: Chapter 18.30.30 JCC Water Supplies; Chapter 18.30.040 JCC
Sewage Disposal; Chapter 18.30.080 and 090 JCC Roads; Chapter 18.35 Article IV JCC
Short Subdivisions. The applicable criteria and requirements are discussed below.
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 11-00040/SUB 11-00001 Page 2 of 17
4. The Jefferson County Comprehensive Plan Rural Residential Land Use Policy LNP 3.3
states:
"Rural residential densities shown on the Land Use Map shall be designated by three (3)
residential land use densities: one dwelling unit per five (5) acres, one dwelling unit per ten
(10) acres, and one dwelling unit per twenty (20) acres in size and subject to the following
criteria:
LNP 3.3.1: A residential land use designation of one dwelling unit per 5 acres (RR 1:5)
shall be assigned to those areas throughout the County with:
a. an established pattern of the same or similar sized parcels (i.e., 5 acres) or smaller
sized existing lots of record;
b. parcels of similar size (i.e., 5 acres) or pre-existing smaller parcels along the coastal
areas;
C. parcels immediately adjacent to the boundaries of the Rural village Centers; and
d. as an overly to pre-existing developed "suburban" platted subdivisions.
e. Parcels designated as Forest Transition Overlay.
The parcel is a legal conforming lot consisting of 11.56 acres and zoned RR 1:5. The subject
property is surrounded by 2 acre tracts and larger. South Discovery Road runs parallel to the
eastern boundary of the parcel and Timberline Road runs parallel to the northern property boundary.
There are two 40 -acre parcels to the southeast of the parcel that are zoned RR 1.20. Approval of
this subdivision request would be consist with the mapped zoning designation of RR 1:5 and the
surrounding parcels. To create an additional lot within the county continues to have a sufficient
variety of rural densities as it has legislatively created RR 1:5; RR1:10 and RR1:20 zones and is
consistent with the Comprehensive Plan Land Use Policy.
5. The Jefferson County Comprehensive Plan Rural Residential Land Use Policy LNP 14.1
states:
"Ensure that land use decisions are based on land use ordinances which are in compliance
with the Critical Areas Ordinance and all applicable state and federal environmental laws."
Both proposed parcels are within a susceptible (SUSC) aquifer recharge area. Septic system
designs will utilize best management practices to reduce potential impacts to the aquifer. The
submitted proposal does not require additional aquifer protection measures. However, during
construction the project shall follow the Best Management Practices (BMPs) and facility design
standards as identified and defined in the Washington Department of Ecology Stormwater
Management Manual for Western Washington. Development of a stormwater site plan is not
required for the development of the plat. No other critical areas were identified on site.
6. The Jefferson County Comprehensive Plan Transportation Policy LNP 17.1 states:
"Encourage development and land use proposals that utilize existing transportation systems
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 11-00040/SUB 11-00001
Page 3 of 17
and provide non -motorized transportation opportunities."
Both proposed lots have an existing direct access from Timberline Road, a private road on a 60 foot
wide easement. South Discovery Road was a territorial road, established prior to statehood.
Jefferson County claims a 60 foot wide right-of-way, 30 feet on each side of the centerline that
existed when the road was conveyed to the State of Washington when statehood was granted. The
preliminary plat depicts the territorial road right-of-way.
South Discovery Road is designated as a proposed on -road bike route within the Jefferson County
Comprehensive Plan.
7. Chapter 18.30.030 JCC Water Supplies:
"When the development or redevelopment of land requires the availability of a supply of
potable water as determined by the Administrator, potable water shall be delivered by a
means approved by the Washington Department of Health and/or Jefferson County Health
and Human Services."
Proposed Lot 1 has an existing on-site individual well. Lot 2 has an existing well that has been
approved as a Group B public water supply known as the "Dog Townsend Kennel" water system
(#AC0093). For final plat, the public water system shall be labeled with it identification number.
Both wells shall be labeled with their respective well tag number and define the use of each well.
An Agreement between the two proposed lots shall be developed regarding responsibility to
maintain and operate the treatment system. Prior to recording of this agreement, it shall be
reviewed by the Environmental Health Department. The Agreement, once recorded, shall be
referenced on the face of the final plat. Each well shall have its 100 foot radius depicted on the
final survey.
The following "Notice to Potential Purchasers" shall be placed on the final mylar:
• The 100 foot sanitary control area for the individual well shall be protected from potential
source of contamination, such as septic tanks and drainfields, sewer lines, underground
storage tanks, roads, vehicles, non-residential structures, barns, feed stations, grazing
animals, enclosures for maintaining fowl or animal manure, liquid or dry chemical storage,
herbicides, insecticides, hazardous waste, or solid waste of any kind or description.
If applicant chooses to record a separate document for Covenants of the public water supply, the
AFN shall be referenced on the face of the plat.
8. Chapter 18.30.040 Sewage Disposal:
"All development shall be provided with an individual, on-site septic system and drainfield
approved by the Jefferson County Health Department in compliance with Chapter 8.15
JCC, unless the Jefferson County Health Department determines that public sewer is
available which would then require connection to the approved public sewer."
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 1 1-00040/SUB 11-00001
Page 4 of 17
Environmental Health completed a site evaluation on July 13, 2011 and examined the soil logs for
proposed Lot 1 and concurred with the soil logs submitted and determined that a system can be
installed on proposed Lot 1. A septic permit (SEP73-134) for the kennel has been abandoned and
shall be stated as such on the face of the final plat with the septic permit number. A new septic
permit (SEP08-73) serves the existing residence and shall also be referenced on the face of the final
plat. The additional septic tank for the kennel shall be graphically portrayed on the face of the final
plat and shall also include the approximate transport line to the homes' septic tank. All existing
improvements, including drainfield areas (primary and reserve areas) shall be graphically portrayed
on the face of the final survey. The language "Septic Design in Progress" shall be removed from
the final survey.
Soil test pits and their respective soil log numbers shall be graphically portrayed on the face of the
final plat and numbered according to the soil test holes.
The following "Notice to Potential Purchasers" shall be placed on the final mylar:
■ The lots, parcels or tracts contained within this subdivision were based on design standards
and regulatory requirements in effect at the time of final approval. Sewage disposal systems
have been approved for the lots, parcels or tracts contained within the subdivision. On-site
sewage disposal systems shall meet design standards and regulatory requirements in effect
at the time of application for a sewage disposal permit. Purchaser should contact the
Jefferson County Health Department for procedures concerning permit applications.
■ Any removal of or major disturbances of soil within the proposed drainfield areas may
create site conditions that are unacceptable for the installation of sewage disposal systems.
9. Chapter 18.30.080 JCC Roads:
"Roads providing access to or within subdivision shall be constructed to the standards of the
Department of Public Works. Public Works road design standards require provision of a 20
foot wide clear zone."
The site is accessed from South Discovery Road by Timberline Road, a private road on a 60 foot
wide fee simple parcel that is jointly -owned by six adjacent property owners. South Discovery
Road is a county rural collector road with 40 MPH speed limit. South Discovery Road was a
territorial road, established prior to statehood. Jefferson County claims a 60 foot wide right-of-way,
30 feet on each side of the centerline that existed when the road was conveyed to the State of
Washington when statehood was established. Timberline Drive is an approximately +/- 16 foot
traveled way. There are driveways and informal turnouts that function as intervisible turnouts.
Timberline Road is adequate to provide site access and fire and emergency vehicle access.
10. Chapter 18.30.080(1)m JCC Roads:
"Easements for private roads providing access to and/or internal circulation within
subdivisions shall be 60 feet in width. Easement width may be reduced on the
recommendation of the Department of Public Works based on a finding that the public
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 11-00040/SUB 11-00001
Page 5 of 17
health, safety, and welfare will be protected and that the easement width is adequate for the
construction and maintenance of roads and utilities. Where reduced access easement widths
are proposed, parallel utilities easements may be required."
Timberline Road is a private road within a 60 foot wide, fee simple parcel that is jointly -owned by
six adjacent property owners.
The surveyor's note on Sheet 2 of the preliminary plat describes the status of Timberline Road. It
does not state whether there is a formal road maintenance agreement, but it does refer to the
applicant's participation in road maintenance expenses since purchasing the property in 2002. The
issue of road maintenance should be clarified on the final plat. If there is a road maintenance
agreement for Timberline Road, it should be referenced on the final plat. If there is a separate
agreement that obligates the owners of the subject property to participate in road maintenance, this
agreement should also be referenced on the final plat. If potential purchasers should expect to
participate in road maintenance, this should be stated on the final plat. If there is not a road
maintenance agreement for Timberline Drive, there should be a notice on the final plat to this
effect.
11. Chapter 18.30.O80(1)n JCC Roads:
"Access easements from the County Road system to the subdivision shall be provided
consistent with the requirements of this Code. Access from the public road system shall be
depicted on the final plat."
South Discovery Road and Timberline Road shall be graphically portrayed on the face of the final
plat. All easements of records shall be graphically portrayed on the final plat with the Auditor's
File Number (AFN) of the easements also reference on the face of the plat.
12. Chapter 18.30.080(1)p JCC Roads:
"Subdivisions shall establish an agreement for the continuing maintenance of private roads
either by recording a separate instrument and referencing said instrument on the plat or by
declaring a maintenance agreement on the plat. The applicant shall submit the maintenance
agreement to the Department of Public Works for review and approval prior to final plat
approval."
The surveyor's note on Sheet 2 of the preliminary plat describes the status of Timberline Road. It
does not state whether there is a formal road maintenance agreement, but it does refer to the
applicant's participation in road maintenance expenses since purchasing the property in 2002. The
issue of road maintenance should be clarified on the final plat. If there is a road maintenance
agreement for Timberline Road, it should be referenced on the final plat. If there is a separate
agreement that obligates the owners of the subject property to participate in road maintenance, this
agreement should also be referenced on the final plat. If potential purchasers should expect to
participate in road maintenance, this should be stated on the final plat. If there is not a road
maintenance agreement for Timberline Road, there should be a notice on the final plat to this effect.
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 11-00040/SUB 11-00001 Page 6 of 17
13. Chapter 18.35.130(a)
"Short subdivisions shall be given preliminary approval, including preliminary approval
subject to conditions, upon finding by the administrator that all of the following have been
satisfied:
(1) The proposed subdivision conforms to all applicable county, state and federal
zoning, land use, environmental and health regulations and plans, including, but not
limited to the following:
i. The Jefferson County Comprehensive Plan: and
ii. The provisions of this Code, including any incorporated standards;
(2) Utilities and other public services necessary to serve the needs of the proposed
subdivision shall be made available, including open spaces, drainage ways, roads,
streets and other public ways, potable water, transit facilities, sewage disposal,
parks, playgrounds, schools, sidewalks, and other improvements to assure safe
walking conditions for students who walk to and from school.
(3) Approving the proposed short subdivision will serve the public use and interest and
adequate provision has been made for the public health, safety and general welfare.
Based on the previous findings, the proposal is found to be consistent with the Comprehensive
Plan, Chapter 18 of the Jefferson County Code and the Jefferson County Coordinated Water
System Plan.
Provisions for open spaces, drainage ways, streets/roads, alleys/other public ways, potable water
supplies, sanitary wastes, and parks and recreation have previously been addressed. The site is not
within the vicinity of Jefferson Transit bus routes. The site is within the Port Townsend School
District. Based on current policy of the school district, students living within the site boundaries
would not be required to walk to school. Bus service would be provided under the current policy of
the district.
There is no probable significant adverse environmental impact. The public interest would be
served by the division of the 11.65 -acre parcel into two lots intended for recreational/residential
use.
Report prepared: October 6. 2011
Dog Townsend Short Plat
MLA 11-00040/SUB 1 1 -0000 1
Page 7 of 17
DOG TOWNSEND SHORT PLAT
PRELIMINARY CONDITIONS
DEPARTMENT OF PUBLIC WORKS:
1. All easements of record shall be graphically portrayed on the final plat with the Auditor's
File Number (AFN) of the easement(s) also referenced on the face of the plat.
2. South Discovery Road and Timberline Road shall be graphically portrayed on the face of
the final plat.
3. The surveyor's note on Sheet 2 of the preliminary plat describes the status of Timberline
Road. It does not state whether there is a formal road maintenance agreement, but it does
refer to the applicant's participation in road maintenance expenses since purchasing the
property in 2002. The issue of road maintenance should be clarified on the final plat. If
there is a road maintenance agreement for Timberline Road, it should be referenced on the
final plat. If there is a separate agreement that obligates the owners of the subject property
to participate in road maintenance, this agreement should also be referenced on the final
plat. If potential purchasers should expect to participate in road maintenance, this should be
stated on the final plat. If there is not a road maintenance agreement for Timberline Road,
there should be a notice on the final plat to this effect.
4. Addresses shall be assigned to all lots. Addresses may be shown on the final plat or may be
applied for at the time of building permit application.
5. Address plates for the lots shall be located in accordance with the provisions of the
Jefferson County 911 Emergency Locator System Ordinance.
6. In accordance with the Jefferson County Fee Schedule Ordinance, the Public Works
Department charges an hourly fee for application and plan reviews, project inspections,
meetings, hearings, and final review. The proponent shall pay all fees incidental to the
proposal prior to final approval. In the event that approval for the proposal is denied by
Jefferson County or the proponent does not complete the proposal, the proponent shall
still be responsible for paying the Department's fees. The Department's fee is currently
$65 per hour.
7. The proponent shall submit a blue line copy of the site plan and lot closure information
prepared by a licensed surveyor to the Department for review. The proponent shall make
any corrections or additions prior to final approval.
8. After all preliminary plat conditions are met; the proponent shall submit a final mylar of
the plat to the Department for approval by the Director of Public Works.
HEALTH DEPARTMENT:
9. The location of the soil test pits and corresponding test pit number shall be graphically
portrayed on the face of the final plat.
10. The septic system (SEP73-134) shown attached to the kennel has been fully abandoned.
This needs to be labeled on the face of the final plat as "SEP73-134 abandoned".
11. Graphically portray the additional new septic tank for the kennel AND include
approximate transport line to the homes' septic tank.
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 1 1-00040/SUB 11-00001
Page 8 of 17
12. Remove the language "Septic Design in Progress" from the survey.
13. All components of existing septic systems, including primary and reserve drainfields shall
be graphically portrayed and labeled with the county assigned septic permit number.
14. Label the public water supply with the water system number #ACO093.
15. Define the use of each well and add their applicable well tag numbers to the face of the
final plat.
16. Bob Leach, NTI, as a part of his water system design recommended that the owners
develop an Agreement between the two parcels regarding responsibility to maintain and
operate the treatment system. The Agreement needs to be submitted for review prior to
recording. Once the agreement is recorded, it shall be referenced on the face of the final
plat.
17. The following notice shall be placed on the face of the final plat under "Notice to
Potential Purchasers"
The lots, parcels, or tracts contained within this subdivision were approved based on
design standards and regulatory requirements in effect at the time of final approval.
Sewage disposal systems have not been approved for the lots, parcels, or tracts contained
within this subdivision. On-site sewage disposal systems shall meet design standards and
regulatory requirements in effect at the time of application for a sewage disposal permit.
Purchaser should contact the Jefferson County Health Department for procedures
concerning permit applications.
Any removal of or major disturbances of soil within the proposed drainfield areas may
create site conditions that are unacceptable for the installation of sewage disposal
systems.
The 100 foot sanitary control area for the individual well shall be protected from potential
source of contamination, such as septic tanks and drainfields, sewer lines, underground
storage tanks, roads, vehicles, non-residential structures, barns, feed stations, grazing
animals, enclosures for maintaining fowl or animal manure, liquid or dry chemical
storage, herbicides, insecticides, hazardous waste, or solid waste of any kind or
description.
DEVELOPMENT REVIEW DIVISION:
18. Based on requirements of Chapter 18.35 JCC Final Short Plat, the final mylar shall be
prepared in accordance with the final short plat checklist. A copy of Chapter 18.35 JCC
is attached.
19. An accurate vicinity map shall be graphically portrayed on the face of the final plat.
20. The final blue line shall depict the name of the subdivision and the county assigned number
of SUB 11-00001 /MLA 11-00040.
21. The names and parcel numbers of adjacent owners shall be deleted from the final mylar
survey.
22. "Discovery Road" shall be changed to South Discovery Road and "Timberline Drive" shall
be changed to Timberline Road on the final mylar survey.
23. See "red -line" for additional corrections, additions, and deletions.
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 1 1-00040/SUB 1 1 -0000 1
Page 9 of 17
24. The Deeds of Trust as identified in the plat certificate shall sign and approve the final mylar
prior to final mylar recording.
24. An updated plat certificate or supplement shall be submitted with the final blueline and
shall be 30 days current.
26. Certificates for the Board of County Commissioners, Clerk of the Board, Director of the
Department of Public Works, Department of Community Development Administrator and
Environmental Health Department need to be added.
27. Utilities and transportation facilities should be installed in the same rights-of-way when
the effect will be to reduce the adverse impacts on the physical environment.
28. Arrangements shall be made by the applicant to install underground utility lines for
electricity and telephone service to all lots prior to final plat approval.
29. The following notices shall be placed on the final plat under "Notice to Potential
Purchasers":
• Outdoor residential storage shall be maintained in an orderly manner and shall
create no fire safety, health or sanitary hazard.
• Not more than 2 unlicensed vehicles shall be stored on any lot unless totally
screened from view of neighboring dwellings and rights-of-way. Such screening
shall meet all applicable performance and development standards specific to the
district in which the storage is kept, and shall be in keeping with the character of the
area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage
of 3 or more junk motor vehicles is prohibited except in those districts where
specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a
permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the
requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage)
yards. In no case, shall any such junk motor vehicles be stored in a critical area.
30. The following notices shall be placed on the final plat under "Notice to Potential
Purchasers":
• Exterior lighting for residential uses shall not exceed twenty feet (20') in height
from the finished grade excepting when such lighting is an integral part of building
or structure. Ground level lighting is encouraged.
• Exterior lighting shall be energy efficient and shielded or recessed so that direct
glare and reflections are contained within the boundaries of the parcel.
• Exterior lighting shall be directed downward and away from adjoining properties
and public rights-of-way. No lighting shall blink, flash, or be of unusually high
intensity or brightness.
• All lighting fixtures shall be appropriate in scale, intensity, and height to the use
they are serving.
31. The following notices shall be placed on the final plat under "Notice to Potential
Purchasers":
Maximum building height shall not exceed 35 feet.
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 11-00040/SUB 11-00001
Page 10 of 17
Maximum impervious surface coverage shall not exceed 25%.
Minimum setbacks from South Discovery Road and any ingress/egress easement
right-of-way shall be 20 feet. Minimum side yard setbacks shall be 5 feet.
32. The following notices shall be placed on the final plat under "Notice to Potential
Purchasers":
• Any further subdivision of the lots within this plat will be subject to the densities
permitted in the Jefferson County Ordinances and Codes in effect at time of such
application. These lots may or may not be further subdivided in the future.
0 Approval of this subdivision does not constitute approval of building or sewage
disposal permits on each lot. Permit approval will be subject to building lot plans,
type of use, contours, and soils on individual lots. Permits will be reviewed in
accordance with site conditions and regulations existing on the date the permits
are applied for.
• Any removal of or major disturbance of soil within the proposed drainfield areas
may create site conditions that are unacceptable of the installation of sewage
disposal systems.
33. The applicant must submit a reproducible copy plus seven (7) paper copies of the
proposed final short plat to the Department of Community Development. The proposed
final short shall contain elements as described in Chapter 18.3 5.120 JCC and shall
include certifications and other requirements as provided in Chapter 18.35.190 JCC and
18.35.370 JCC.
NOTICE: The sale of lots prior to final short plat approval is unlawful.
EXPIRATION: Preliminary approval will expire on October 6, 2014. The Department of
Community Development shall not be responsible for notifying the applicant of impending
preliminary short plat expiration.
SUBMISSION: It is the responsibility of the applicant or authorized representative to ensure the
final short plat is submitted in accordance with the conditions of preliminary approval. This
includes paying all property taxes and submitting a recording fee for the final plat and supply an
updated plat certificate (within 30 days of submittal), all of which is outlined in the final short
plat checklist.
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 1 1-00040/SUB 1 1 -0000 1
Page 11 of 17
Chapter 18.35.120 JCC Preliminary short plat contents.
(1) A preliminary short plat shall be submitted on one or more sheets and shall provide the
information described below. All specifications for required improvements shall conform
to the development standards contained in Chapter 18.30 JCC.
(a) The name of the proposed subdivisions together with the words "Preliminary Short Plat";
(b) The name and address of the applicant;
(c) The name, address, stamp and signature of the professional engineer or professional
land surveyor who prepared the preliminary plat;
(d) Numeric scale (50 feet or fewer to the inch), graphic scale, true north point, and date of
preparation;
(e) Identification of all land intended to be cleared, and the location of the proposed access
to the site for clearing and grading during site development or construction; and
(f) A form for the endorsement of the administrator, as follows:
APPROVED BY JEFFERSON COUNTY
Department of Community Date
Development Administrator
(2) The preliminary plat shall contain a vicinity sketch sufficient to define the location and
boundaries of the proposed subdivision with respect to surrounding property, roads, and
other major constructed and natural features.
(3) Except as otherwise specified in this chapter, the preliminary short plat shall contain the
following existing geographic features, drawn lightly in relation to proposed geographic
features:
(a) The boundaries of the property to be subdivided, and the boundaries of any adjacent
property under the same ownership as the land to be subdivided, to be indicated by bold
lines;
(b) The names of all adjoining property owners, or names of adjoining developers;
(c) All existing property lines lying within the proposed subdivision, including lot lines for lots
of record which are to be vacated, and all existing property lines for any property
adjacent to the subject property which is under the same ownership as the property to
be subdivided (as described in JCC 18.35.110(3)) shall be shown in broken lines;
(d) The location, right-of-way widths, pavement widths and names of all existing or platted
roads, whether public or private, and other public ways within 200 feet of the property to
be divided;
(e) The location, widths and purposes of any existing easements lying within or adjacent to
the proposed subdivision;
(f) The location, size and invert elevation of sanitary sewer lines and stormwater
management facilities lying within or adjacent to the proposed subdivision or those that
will be connected to the subdivision as part of the proposal (if applicable);
(g) The location and size of existing water system facilities including all fire hydrants lying
within or adjacent to the proposed subdivision or those which will be connected to as
part of the proposed subdivision (if applicable);
(h) The location, size and description of any other underground and overhead facilities lying
within or adjacent to the proposed subdivision (if applicable);
(i) The location of any environmentally sensitive areas as described in Article VI -D of
Chapter 18.15 JCC, including all floodplains lying within or adjacent to the proposed
subdivision;
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 1 1-00040/SUB I 1 -0000 1
Page 12 of 17
(j) The location of existing sections and municipal corporation boundary lines lying within or
adjacent to the proposed subdivision;
(k) The location of any well and associated setbacks existing within the proposed
subdivision;
(1) The location of any individual or on-site sewage disposal system existing within the
proposed subdivision;
(m) Existing contour lines at intervals of five feet, labeled at intervals not to exceed 20 feet;
(n) The location of any existing structures lying within the proposed subdivision; existing
structures to be removed shall be indicated by broken lines, and existing structures not
to be removed shall be indicated by solid lines.
(4) The preliminary plat shall show the following proposed geographic features:
(a) The boundaries in bold solid lines of any proposed lots, tracts or parcels, the area and
dimensions of each proposed lot, tract or parcel, and the proposed identifying number or
letter to be assigned to each lot, tract or parcel, and block (if applicable);
(b) The right-of-way location and width, the proposed name of each road, street or other
public way to be created and the estimated tentative grades of such roads; where
roadways may exceed the maximum allowable grade or alignment, the director of the
department of public works may require sufficient data, including centerline profiles and
cross-sections, if necessary, to determine the feasibility of said roadway;
(c) The location, width and purpose of each easement to be created;
(d) The boundaries, dimensions and area of public and common park and open space
areas;
(e) Identification of all areas proposed to be dedicated for public use, together with the
purpose and any condition of dedication;
(f) Proposed final contour lines at intervals of five feet; final contour lines shall be indicated
by solid lines; contour lines shall be labeled in intervals not to exceed 20 feet;
(g) The building envelope, as defined in JCC 18.10.020, shall be indicated for each lot;
(h) Proposed monumentation;
(i) Proposed location and description of all individual or community wells, or water system
improvements, including fire hydrants (if applicable);
Q) Proposed location and description of all sewage disposal improvements, including (if
applicable) profiles and all pump stations and their connections to the existing system;
(k) Proposed location and description of all stormwater management improvements;
(1) Proposed road cross-sections, showing bicycle and pedestrian pathways, trails and
sidewalks (if applicable);
(m) Proposed type and location of road lighting (if applicable);
(n) Proposed type and location of landscaping (if applicable);
(o) Proposed location and description of transit stops and shelters (if applicable);
(p) Proposed covenants, conditions and restrictions (CC&Rs) on development (if
applicable).
(5) Upon review of an application, the administrator may require additional pertinent
information, as deemed necessary, to satisfy any other regulatory requirements. The
administrator may also waive specific submittal requirements determined to be
unnecessary for review of an application. In such event, the administrator shall
document the waiver in the project file or log. [Ord. 11-00 § 7.3(4)]
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 11-00040/SUB 1 1 -0000 1
Page 13 of 17
Chapter 18.35.190 JCC Accompanying documents — Final short plat.
(1) In cases where any restrictive deed covenants or CC&Rs will apply to lots or parcels
within a subdivision, a type written copy of such covenants, bearing all necessary
signatures, shall be submitted along with the final plat. Where the recordation of specific
deed restrictions or CC&R provisions have been required as a condition of preliminary
plat approval, the administrator shall approve and sign the deed restriction or CC&Rs
prior to final plat approval.
(2) The final plat shall be accompanied by a current (i.e., within 30 days) title company
certification of the following:
(a) The legal description of the total parcel sought to be subdivided;
(b) Those individuals or corporations holding an ownership interest and any security interest
(such as deeds or trust or mortgages) or any other encumbrances affecting the title of
said parcel. Such individuals or corporations shall sign and approve the final plat prior to
final approval;
(c) Any lands to be dedicated shall be confirmed as being owned in fee title by the owner(s)
signing the dedication certificate;
(d) Any easements or restrictions affecting the property to be subdivided with a description
of purpose and referenced by the auditor's file number and/or recording number; and
(e) If lands are to be dedicated or conveyed to the county as part of the subdivision, an
American Land Title Association (A.L.T.A.) policy may be required by the director of the
department of public works.
(3) All maintenance, performance and guarantee bonds or other guarantees as may be
required by the director of the department of public works and the approved
improvement method report to guarantee the acceptability and/or performance of all
required improvements. [Ord. 11-00 § 7.3(11)]
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 1 1-00040/SUB 1 1 -0000 1
Page 14 of 17
Chapter 18.35.370 JCC Preparation of a final long plat.
The final long plat shall be prepared in accordance with the following requirements:
(1) The final plat shall be prepared by a land surveyor licensed by the state of Washington
or a Washington state licensed engineer.
(2) Six paper copies of the final long plat shall be submitted, measuring 18 inches by 24
inches in size, allowing one-half inch for border.
(3) A final long plat shall contain the following information:
(a) The name of the subdivision;
(b) Legal description of the property being subdivided;
(c) Numeric scale, graphic scale, true north point and date of preparation of the final plat;
(d) The lot line of the plat, referenced to county (USC&GS) datum and based on an
accurate traverse, with angular and linear dimensions and bearings;
(e) The exact location, width and name of all roads, streets, alleys and other public ways
within and adjacent to the subdivision;
(f) The exact location, width and purpose of all easements and dedications for rights-of-
way provided for public and private services and utilities;
(g) True courses and distances to the nearest established road lines, or sections or quarter
section corner monuments which shall accurately locate the subdivision;
(h) Section lines accurately tied to the lines of the plat by distances and courses;
(i) All lot and block numbers (if applicable) and lines, with accurate dimensions in feet and
hundredths of feet;
Q) All house address numbers as assigned by the county;
(k) Delineation of the building envelope of each lot;
(1) The radii, internal angles, points of curvature, tangent bearings and lengths of arc;
(m) The accurate location of each permanent control monument;
(n) All plat meander lines or reference lines along bodies of water shall be established as
above, but not farther than 20 feet from the high water line of such body;
(o) Accurate outlines and legal descriptions of any areas to be dedicated or reserved for
public use, with the purpose of such dedication or reservation and any limitations
indicated thereon and in dedication;
(p) Accurate outlines of any area to be reserved by the deed covenant for common use of
owners of property within the subdivision, together with the purposes of such
reservation;
(q) Any restrictions or conditions on the lots or tracts within the subdivision, as required by
the county or at the discretion of the property owner, including but not limited to
environmentally sensitive areas buffers;
(r) The auditor's file number of all documents and conveyances recorded with the Jefferson
County auditor associated with preliminary or final plat approval;
(s) The name and seal of the Washington State licensed land surveyor or Washington
State licensed engineer responsible preparation of the final plat, and a signed
certification on the plat by said surveyor to the effect that it is a true and correct
representation of the land actually surveyed by him or her, that the existing monuments
shown thereon exist as located and that all dimensional and geodetic details are correct;
(t) A signed, notarized certification stating that the subdivision has been made with the free
consent and in accordance with the desires of the all persons with ownership and/or
security interests in the property. If the plat includes a dedication, the certificate or a
separate written instrument shall contain the dedication of all roads and other areas to
the public, any individual or individuals, or to any corporation, public or private, as shown
on the plat. Such certificate or instrument shall be signed and acknowledged before a
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 1-00040/SUBI 1 -0000 1 Page 15 of 17
notary public by all parties having any interest in the land subdivided. The owner shall
waive all claims against the county, on behalf of the owner and the owner's successors
and assigns, which may be occasioned by the establishment and/or construction of any
roads, streets, storm drainage improvements or other improvements;
(u) An offer of dedication may include a waiver of right of direct access to any road from
any property. Such waiver may be required by the director of the department of public
works as a condition of approval. Any dedication, donation or grant as shown on the
face of the plat shall be considered as a quit claim deed to the said donee or grantee for
use for the purpose intended by the donation or grant;
(v) Signature blocks for the appropriate certification of the county auditor, director of the
department of public works, director of the public health department, and DCD
administrator, as follows:
DIRECTOR OF PUBLIC WORKS
CERTIFICATE
I hereby certify to the best of my knowledge that this final plat is in compliance with the
certificate of improvements issued pursuant to the Jefferson County Unified
Development Code and is consistent with all applicable county improvement standards
and requirements in force on the date of preliminary plat approval, this day of
, 20_
Director, Jefferson County Department
of Public Works
DEPARTMENT OF COMMUNITY
DEVELOPMENT ADMINISTRATOR'S
CERTIFICATE
I hereby certify that on this day of , 20_, that this final plat is
in substantial conformance with the preliminary plat and any conditions attached thereto,
which preliminary plat was approved by Jefferson County on the day of
20
Administrator, Jefferson County
Community Development Department
JEFFERSON COUNTY PUBLIC HEALTH DIRECTOR
CERTIFICATE
Approved by public health department the on this day of 20_.
Director, Jefferson County Public Health Dept.
Report prepared: October 6, 2011 .
Dog 'Townsend Short Plat
MLAI1-00040/SUB11-00001 page 16 of 17
TREASURER
All taxes and/or assessments due are paid in full on this day of
20
Jefferson County Treasurer
(w) A form of the approval of the County assessor, as follows:
ASSESSOR'S APPROVAL
Examined and approved this day of , 20
Jefferson County Assessor
Attest:
Deputy Jefferson County Assessor
(x) A form for the certificate of the Jefferson County recorder, as follows:
RECORDING CERTIFICATE
Filed for record at the request of Jefferson County this day of
20 , at minutes past _M., and recorded in Volume of Plats, page
Records of Jefferson County, Washington.
Jefferson County Recording Number
Manager
Superintendent of Records
(y) Any additional pertinent information as required at the discretion of the director of the
department of public works or the DCD administrator.
(4) All signatures or certifications appearing on a final plat shall in be reproducible black ink.
[Ord. 11-00 § 7.4(11)]
Report prepared: October 6, 2011
Dog Townsend Short Plat
MLA 1 1-00040/SUB 1 1 -0000 1
Page 17 of 17
JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street " Port Townsend " Washington 98368
360/379-4450 • 360/379-4451 Fax},
www.co.jefferson.wa.us/Gommd.o;velop I'lent
Master Permit Application
MLA: Il -40
Project Description (include separate sheets as necessary):
+n ( o
Tax Parcel Number: 00, 1 Z o 3 O I o Property Size: / [ . 5� /tCjtt�S (acres/square feet)
Site Address and/or Directions to Property:
c Ti Al bt--IlAt � o r i— W EWO t/A_ b JFa 0'
Property Owners) of Record: Am p^ 1 W;b h
Telephone: _3 C c 3 -33Z-t Fax: -3 email star an Jam. w CIA 4
Mailing Address: Sri'
Applicant/Agent (if different from owner): L
Telephone: 4 3 " 3 t- `i Fax:J - ! if r( email:..+ t•► �fiMc� (_ +`"
Mailing Address: 5 u� u 5 6L t r
What kind of Permit? (Check each box that applies ❑ Lot or Road Segregation
❑Building ❑ Critical Areas Stewardship Plan
❑ Demolition Permit ❑ Variance (Minor, Major or Reasonable Economic Use)
❑ Single Family ❑ Garage Attached / Detached 0 Conditional Use [C(a), C(d), or C] **
❑ Manufactured Home ❑ Modular 0 Discretionary "D" or Unnamed Use Classification
❑ Commercial* ❑ Special Use (Essential Public Facilities) **
❑ Change of Use ❑ Boundary Line Adjustment
❑ Address ❑ Road Approach :Short Plat **
❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan **
❑ Propane ❑ Long Plat **
❑ Sian ❑ Planned Mural Residential Development (PRRD)/Amendments *'
❑ Allowed "Yes" Use Consistency Analysis ❑ Plat Vacation/Alteration **
❑ Stormwater Management ❑ Shoreline Master Program Exemption/Permit Revisions **
❑ Site Plan Approval Advance Determination (SPAAD) * 0 Shoreline Management Substantial Development **
Temporary Use ❑ Shoreline Management Variance
❑ Wireless Telecommunication * ❑ Comprehensive Plan/UDC/Land Use District Map Amendment
❑ Forest Practices Act/Release of Six -Year Moratorium ❑ Jefferson County Shoreline Master Program Amendment
* May require a Pre —Applicadon Conference ❑ Tree Vegetation Request
—Requires a Pre -Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
/ DESIGNATION OF GENT
I hereby designate `� L A y -e l - to a s my agent in matters relating to this application for permit(s).
OWNER SIGNATURE c� Date:
By signing this application form, the owner/agent attests the information provided herein, and in any attachments, is true and correct to the best of
his, her or its knowledge. Any material falsehood or an o ission of a material fact made by the owner/agent with respect to this application packet
may result in this permit being null and void.
I further agree to save, indemnify and hold harmless Jefferson County against all liabilities, judgments, court costs, reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application
review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applicatio t t h r he wants prior notice.
Signature: Date: i �Z_ Z—/(
The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or
endangered species and Could lead to a potential "take" of an endangered species as those terms are defined in the federal law known as the
"Endangered Species Act" or "ESA," Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
permit has been issued will not violate the ESA. Any individual, group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s) even if you are in compliance with the Jefferson County development code. The Applicant acknowledges that he, she or it holds individual
and non -transfer bl res Bibi y for adhering to and complying with the ESA. The Applicant has read this disclaimer and sJ ns and dates it below.
Signature: Date: 1!407 ! l{
I
,1. CiO.-