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Home My WebLink About002EP 2- Zr&,olq.f WW-ooW DEPARTMENT OF COMMI.INITY DEVELOPMENT 621 Shcridan Strcet, Port -fownsend, W,\ 98368 'l'el: 360.379.'1450 | lrax: 360.319.445'l \xtb: I i-mail: dcd@co.icffcrson.wa.us fl0V o R 20tr. PERMTT APPLTCATION , .Errensorv Steps in the Permit Process: -Review application checklist to ensure all information is completed prior to submitting application. -Make sure septic has been applied for and water availability has been proven. -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application; it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additionalfees may apply after review and payment is required before permit is issued For Department Use Only Related Application fs: Building Permit # MLAf COUNTY DCD Site lnformation co c_Te- Assessor Tax Parcel Number:O\\<: Site Address and/or Directions to Property .Ve-lte- \^)o. ct e_Access (name of street(s)) from which access will be gained Descript ion of Work (include proposed uses): Present use of property Wastewater - Sewage Disposal This property is served by Port Townsend or Port Ludlow sewer system? lf not served by sewer identified above, identify type of septic system below YES NO x. Tyoe of Sewage System Serving Property: K Septic Septic Permit #: _ Community Septic Name of System: Are other residences connected to the septic system? Additions or repairs to sewage system: ls it a complete or partial system installation: Has a reserve drainfield been designated? Date of Last Operations & Maintenance check: Case #: ,NO iulx Complete _ Yes _ _ Partial No- Attach last report to application Describe or attach any drainfield easements, covenants or notices on title, which may impact the property lnformation f-L( _ Please contact Authorized Agent/Representative with project info. (select only one) Property Owner \r 8tS Aoq ^ g\')6Ll I n WrCrrz:I€i -\ r) c:C)L E-mail Address Property Owner: Date Name: Address: Phone #: Note: For attach a sheet with each information andwith Authorized other than Name: Address: Phone #: \-\): E-mailAddress: 'T Professional:ls this an for this project?NO YES Engineer Architect_ _Surveyor _ _Contractor License # Consu ltant Name: Address: Phone f:E-mailAddress: Professional:ls this an for this project?NO YES Engineer Architect _ _ Surveyor _ Contractor License # Consu lta nt Name: Address: Phone #:E-mail Address Professional:ls this an Authorized for this project?NO YES Engineer Architect_ _Surveyot _ _Contractor License # Consultant Name: Address Phone # The authorized agent/representative is the primary contact for all project-related questions and correspondence. The County will mail / e-mail requests and information about the application to the authorized agent/representative and will copy (cc) the owner noted below. The authorized agent/representative is responsible for communicating the information to all parties involved with the lication. lt is theapp Cou il ility of authorized agent/representative and owner to ensure their mailbox accepts County email (i.e., or sent to U nk mai (,n By signing this application form, the owner/agent attests that the information provided herein, and in any attachments, is true and correct to the best of his or her knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in making any issued permit null and void. Print Name, T>ic,.- I UJ\ llia^wu"Signatu re l)crrril \rrnlicrtrrn t(^8€a/{ \ooS YL,.^) t\-kr.\a^ DA Na.r\s Lrn , ( rV . aR3 /O E-mail Address: DEPARTMENT OF COMMUNITY DEVELO 621 Sheridan Street, Port Townsend, WA 98368 Tel: 360.379.4450 | Fax: 360.379.445'l Web: www.co. iefferson.wa. us/commun itydevelooment E-mail: dcd@co.iefferson.wa.us SUPPLEMENTAL APPLICATION COTTAGE INDUSTRY Nav xn 2AB GFFENSOTV courvryCIco n,tu#Pnolecr/appllcANT NAME !r\ \\ta^'u--s o n Tax ParcelNumber: {oO \\ O-'iO \3 I Propefi Size: (include dwelling Proposed square footage ofthe area used sqqaqe feet for business activities: unit, and any structure) detached or attiached 23g,70g.g 2,000 feet Please answer all of the following questions to the best of your ability: 1 Describe the proposed home occupation or activity. We will be drying, trimming, and packaging recreational maruuana. All of the processing will take place indoors. 2. List the number of residents who will be working for the home occupation. One 3. List the hours of operation and the location of any business sign. There will be no sinage on the property. Hours of operation will take place between 9:00AM and 6:00PM. 4. Describe provisions for off-street parking for the proposed activity. There wil be 2 spaces available at the residence. At the facility there will be two ADA and three regular parking spots. 5. Describe any noise, vibration, glare, fumes, odors, electrical interference or other impacts will be generated by the business operation. There will be no noise, fumes, or other annoyances generated by the proposed business. Odors will be eleminated throigh activated carbon filters and can filters. 6. Describe any excess levels of noise generated by the proposed use or activity: There will be no excessive levels of noise generated by the business. 7. Describe how granting the permit will not disrupt adjacent permitted uses. All of the processing of marijuana will take place indoors and not be visable or noticeable to the surrounding properties. The proposed business will take place on a 5.48 acre plot with no established residential dwellings surrounding it. We plan on keeping a border of the current dense forest around all sides of the property as a natural visual barrier. 8. Do you plan to construct another structure to accommodate the home occupation? lf so, please describe We plan on building a single family residence along with a 5,000 sq ft. building which we will grow marijuana in and process marijuana in 2,000 sq ft. of that building. ln the future we plan on building another 5,000 sq ft. building for the sole puropse of growing marijuana. 9. Describe the quantities and materials which will be stored outside. No products or materials relating to processing marijuana will be located outside ACKNOWLEOGEilENT By signing the application form, the applicanUowner attests that the information provided herein is true and conect to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicanUowner with respect to this application packet may result in this permit being null and void. /t-G-\or8 (onre) [MfE: Representative authorization is required if application is not signed by the Owner.] h--, l),74--Lr2--- lneer-rcnr.rr ffio"irri REeRESENTATvc srcurune) ooaE r-l 3 $ O)a6\t tt -t q) (D I l'-o -J LL \o F-k { ) J L J lJ J L U d s\?F-. (o *?s: € ,'.I$3 ;$sl\s sns- I s 101 j, ^aa3B- t08 11 bo N lt {,d F * "rJ ri rl 'cl o e-'.6(r +a c; O) 6 -J {j n/(Lc tJ_ f, -'-lk -j,3 v *$ I*-j L{J bp arfJ f.. 00tn 7( pr @ a \ f)\ "e , t l'/.lt I I R N\(o \ (o Sa|o\h = ,00't6z eS r$ *0 @ *$ G 6Gr € C= cf,z, \t- (j F-H-,qo) *-B-',4 F3GOt^ON282GOHNltut.? () J -Ja- aoo =f, $tsqj d---iOa\E -\cor5 oSef,oozLL { _l bo6aa $ =o,s p 0o 0O = d I-f a v,i&*,# 1.l t-n t t\t'oI-a 73 .>t-co>r) -'o l-t i.,fl d4.tg- Pd tJ. l ne rN =e\J lf).-J ZlZ (t\ ciI I '-!. _*.#{ __.J ,lz'6ll :7 ,02'9t/. = Ar V eO ,/L )4 u{oo \ft$l trg 6o e$ @ oqx hl .1,",1 k F-\ .o _Q 6 U \{N i'$ :Q* 5 t' U b\l6$N a J) J-1, S U t'- -4 -)t 4o t{.ilc)r'1 Ct,9s; 00 0;\l:-a U) 4d\4 t'Ih*ls{, \ a\'ar, .( t@ ,60.60 nl., ,,2 Critical Areas H illshade 1:1,128 Date:22812019 are on an 'AS-|S" basis, without warranty of any type, expressed or implied, but not limited to any raarranty as to their performance, merchantability, or fitness for any particular purpose.map a muEte sweys q fcr bcalinq acfud property anY x