HomeMy WebLinkAbout030821_ca08�,ON to JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street I Port Townsend, WA 98368
360-379-4450 1 email: dcd@co.jefferson.wa.us
tS�f+NC'�� http://www.co.jefferson.wa.us/260/CommunityDevelopment
Jefferson County
Board of County Commissioners
Consent Agenda Request
To: Board of County Commissioners
Philip Morley
Through: Patty Charnas, Director r(('
From: Shannen Cartmel, Associate PlannerSW
Date: Consent Agenda for March 8, 2021
Subject: Final Short Plat Approval for "LSB" Short Plat, MLA20-00034 / SUB2020-00004
Statement of Issue: The final short plat approval of a two -lot short plat located at 52 Bishop Hill Road,
Chimacum. Requested final approval by the Board per Jefferson County Code (JCC) Section 18.35.200 and
RCW58.17.170. Applicants are Loren Bishop and Linda Lopeman.
Analysis: Staff determined the application as submitted on February 18, 2020. On February 24, 2020, staff
deemed the application complete, as it met the criteria of JCC Section 18.35.100. On December 7, 2020, staff
issued the permit approval, with written conditions and findings for final plat approval. The applicant has met all
conditions and each department has signed the survey mylar. RCW 58.17.195 requires a written finding of fact
that the proposed short subdivision conforms with any applicable zoning ordinances or other land use controls
that may exist.
Alternatives: The requested action is mandatory per RCW 58.17.170 and JCC 18.35.130(1)(c).
Fiscal Impact: There is no identifiable fiscal impact related to this request for final plat approval. The applicant
has paid the full -year property taxes for 2021 of $2275.51.
Recommendation: Per the Jefferson County Ordinance and State Law, the Department of Community
Development requests that the Board of County CoCmmissioners grant final short plat approval and adopt the
written findings and conclusions.
��ON COCA
ti c JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
UNIFIED DEVELOPMENT CODE
11 c't�� TYPE II LAND USE PERMIT
APPLICANT: LOREN BISHOP
LINDA D LOPEMAN
52 BISHOP HILL RD
CHIMACUM, WA 98325-9709
DATE ISSUED: December 07, 2020
DATE EXPIRES: December 07. 2023
MLA NUMBER: MLA20-00034
PROJECT PLANNER: Shannen Cartmel
PROJECT DESCRIPTION: SUB20-00004 - TWO LOT SHORT PLAT. Subdivide 22.81 acres into two parcels, Lot 1 consisting of 10.07
acres and Lot 2 consisting of 12.74 acres. Both lots have existing single-family residences and septic systems with individual wells. All
roads and accesses are existing.
PROJECT LOCATION:
Parcel No. 901 353 013: Bishop Short Plat Lot 4 (Tax 29) BND by BLA #108779 within Section 35, Township 29 North,
Range 1 West, WM; located at 223 Bishop Hill Road, Chimacum, WA 98325
CONDITIONS:
1.) This preliminary approval is for a Two Lot Short Plat only. Final approval is subject to all conditions and review
by County Commissioners. Any future permits on this site are subject to review for consistency with applicable
codes and ordinances and does not preclude review and conditions which may be placed on future permits.
2.) ASSESSOR'S OFFICE:
a. All references to the year 2019 (DCD Declaration and MLA #) on the survey need to be changed to 2020
b. The name of the short plat will need to be changed to "LSB Short Plat" as there are already several "Bishop"
plats.
c. Description errors: the 8th paragraph of the description stat starts as Thence N89"49'49"W the footage
according to the survey is 658.71'.
This parcel is a portion of Lot 4 Bishop Short Plat, as recorded in Volume 1 of Short Plat, Page 93; please
include it in the description.
3.) Written comments were not provided by the PWD as the roads are private with road maintenance agreements
for Bishop Hill Road and Bishop Hill Circle and are existing. A 30-foot wide private easement exists off of
Bishop Hill Road across Lot 2 (east/west) that currently serves an existing single-family residence. An email
dated June 1, 2020, from Brian Tracer, Assistant Fire Chief (EFJR) stated "I don't see any issues".
4.) ENVIRONMENTAL HEALTH (water):
a. Water quality and quantity information on each potable well must be submitted. Quality must be established
by submitting a well log. All three wells need to have water quality samples done for bacteria, nitrate, and
chloride. The two potable water wells have been tested for bacteria and nitrate only. Water quality test results
for bacteria, nitrate, and chloride must be submitted that are less than 3 years old.
b. Place the note at the irrigation well "hose bib only/no water lines" on the face of the survey.
c. Please clarify how the irrigation well and the potable source on proposed Lot 1 is plumbed and verify there is
no cross -connection between the two sources and there is a physical disconnection between the two.
d. Is the irrigation well also being used by the northerly adjoining parcel or is it just potable water? Show the
water lines from the irrigation well on the plat, and label potable lines vs irrigation lines.
e. Prior to final plat approval, a Protective Covenant shall be recorded for any portion of the 100' radius that
encumbers adjacent properties. Recorded AFN numbers shall be referenced on the face of the final plat. The
form recorded had errors. The NTT needs to be complete and correct parcel numbers verified. The NTT must
Page 1 of 3
be re -recorded as a correction after review from Environmental Health. When the notice to title is corrected and
re -recorded, a note must be placed associated with the well on Lot 2 that states "Notice to title for Protective
Radius recorded underAFN#
5.) No further information is required as each septic has been finaled with designated reserve drainfields.
6.) DEPARTMENT OF COMMUNITY DEVELOPMENT
a. Based on the requirements of Chapter 18.35 Jefferson County Code (JCC) Final Short Plat requirements, the
final mylar shall be prepared in accordance with the final short plat checklist located in JCC 18.35.
b. An accurate vicinity map shall be graphically portrayed on the face of the final plat.
c. The final blue line shall depict: the new name of the subdivision, LSB Short Plat, and the county assigned
number of MLA20-00034/SUB20-00004 on all sheets of the mylar.
d. The existing legal description as described in the updated plat certificate shall be referenced on the face of
the final mylar.
e. An updated plat certificate or supplement shall be submitted with the final blueline and shall be 30 days
current.
f. Submit the lot closure information with the final bluelines and updated plat certificate.
g. On Sheet 2, identify the acreages for Lot 2; both sides of the road.
h. Arrangements shall be made by the applicant to install underground utility lines for electricity and telephone
service to all lots before final plat approval. 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.
i. All graphics shall meet the recording requirements for legibility.
j. Consistent with RCW 84.56.345, current year and, if applicable, all delinquent property taxes including
compensating tax from open space program shall be paid in full before the Treasurer signing the mylar and
paper copies of the short plat.
k. The applicant must submit a reproducible copy (11" x 17") plus seven (7) paper copies of the proposed final
short plat to the Department of Community Development. The proposed final short plat 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.
I. All signatures and seals shall be in black ink on Mylar.
m. Deeds of Trust as identified in the plat certificate shall sign and approve the final mylar before final mylar
recording.
n. Proponent may enter into a surety agreement with the Department of Public Works before final plat approval
as an alternative to completing the installation of required improvements. The surety shall not be accepted for
the development of water supply facilities, other than distribution facilities. The surety shall be for an amount
equal to 200 percent of the cost of required improvements, shall not exceed one year, and must be in a form
acceptable to Jefferson County. Acceptable forms of surety include bonds, open account agreements, and
irrevocable letters of credit. The surety must be accompanied by an estimate of the cost of all improvements
prepared by a licensed engineer. The estimate shall be approved by the Public Works Department before
acceptance.
o. The following shall be placed under "Notice to Potential Purchasers"
1. 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 the time of such application. These lots may or may not be further
subdivided in the future.
2. 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.
Page 2 of 3
J
7.) NOTICE: The sale of lots before final short plat approval is unlawful.
8.) EXPIRATION: Preliminary approval will expire on December 7, 2023. The Department of Community
Development shall not be responsible for notifying the applicant of impending preliminary short plat expiration.
9.) 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.
10.) Geologically hazardous areas are areas that because of their susceptibility to erosion, sliding, earthquake, or
other geological events, are not suited to siting commercial, residential, or industrial development consistent
with public health or safety concerns.
11.) The following shall be placed as a Notice to Potential Purchasers on the face of the plat:
NOTICE TO POTENTIAL PURCHASERS
Landslide Hazard Areas and their associated 30-buffers shall remain naturally vegetated. No alterations shall be
made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator.
If any inadvertent alteration of the buffer occurs during the implementation of the approved project, the project
proponent shall contact DCD to discuss mitigation measures to be reviewed for approval by DCD.
12.) The following shall be placed as a Notice to Potential Purchasers on the face of the plat:
NOTICE TO POTENTIAL PURCHASERS
Permanent physical separation of the landslide hazard area buffer area shall be installed and permanently
maintained. The buffer shall be maintained in a natural condition.
13.) The following shall be placed as a Notice to Potential Purchasers on the face of the plat:
NOTICE TO POTENTIAL PURCHASERS
An additional setback of five (5) feet is required from the edge of the 30-foot landslide hazard area buffer to any
future proposed development.
FINDINGS:
1.) The Administrator finds 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 the Hearing Examiner within
fourteen (14) calendar days of the date of issuance of this land use decision. For more information related to administrative
appeals see JCC 18.40.330.
December 07, 2020
UDC Administrator Date
MLA20-00034
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street I Port Townsend, WA 98368
360-379-4450 1 email: dcd@co.jefferson.wa.us
www.co.jefferson.wa.us/commdevelopment
Page 3 of 3
�, O N
°o� JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
�y 621 Sheridan Street, Port Townsend, WA 98368 1 Web: www.co.jefferson.wa.us/communitydevelopment
ISO Tel: 360.379.44501 Fax: 360.379.4451 1 Email: dcd(cDco.jefferson.wa.us
SquareONE Resource Center I Building Permits & Inspections I Development Review I Long Range Planning
STAFF REPORT
TO THE UDC ADMINISTRATOR
Re: Type II 2 Lot Short Subdivision
"Bishop Short Plat"
File No.: MLA20-00034 / SUB20-00004
Applicant: Loren Bishop
Linda D. Lopeman
52 Bishop Hill Road
Chimacum, WA 98325-9709
Project Planner: Shannen Cartmel, Associate Planner
FINDINGS,
CONCLUSIONS, AND
CONDITIONS
SUMMARY OF APPLICATION AND RECOMMENDATION
Date of Application: The application was received on February 18, 2020, and deemed complete
pending submittal of the survey maps. The application was deemed complete on February 24. 2020.
Application / Proposal: Type II application for a 2-lot residential (RR 1:10) short plat consisting of 22.81-
acres known as the LSB Short Plat. Lot 1 is 10.07 acres and Lot 2 is 12.74 acres. Lot 1 (western lot) has
an existing house, detached carport, septic and drainfields, 2 party well (Well Agreement AFN 610537),
and existing private access (Bishop Hill Road) with a proposed 30-foot-wide ingress, egress, and utility
easement for the benefit of Lot 1. There is also an existing well for irrigation purposes only identified on
Lot 1. Lot 2 (eastern lot) consists of 12.74 acres and has an existing well (ID #BKZ795) and a primary and
reserve drainfield designated. A building permit for a new single-family residence with a garage was
issued on July 29, 2020, for proposed Lot 2. Access to Lot 2 is via the existing Bishop Hill Road per AFN
372681 which is a private road.
Recommendation: Approval with conditions.
BACKGROUND INFORMATION
Applicant: Loren Bishop and Linda Lopeman
Representative: Scot Clark, Clark Land Office, P.O. Box 2199, Sequim, WA 98382 (surveyor)
Location: APN 901-353-013
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004
Site Conditions: The subject parcel is 22.81 acres in size. The highest elevation is approximately mid -
center of the parcel which county mapping identifies the elevation as 419 feet. The north corner on the
western boundary is approximately 309 feet in elevation and the southwest corner is approximately 304
feet in elevation. The mapped landslide hazard area (identified on the mapping as heavily treed, ranges
from approximately 393 feet in elevation at the north boundary just before the clearing to 397 feet in
elevation at the southern boundary just before the clearing on the mapping. The northeast corner is
approximately 407 feet in elevation and the southeast corner is approximately 394 feet in elevation.
Bishop Hill Road at its northern portion of the parcel is approximately 419 feet in elevation and the
southern portion of Bishop Hill Road at the southern boundary is approximately 393 feet in elevation. As
stated under "application/proposal" above the parcel overall has several improvements on it.
Surrounding Area: The majority of the surrounding properties are developed with single-family
residences, wells (individual and two-party), septic systems, and private roads. Parcels range in size from
1.27 acres (to the east) and approximately 657 feet to the immediate west is an 84-acre parcel zoned
AP-20. Several of the surrounding properties have been rezoned to AP-20 or AL-20. Within the
immediate vicinity of the subject parcel, all parcels are zoned RR 1:10 as well as just south of Egg and I
Road.
Comprehensive Plan Designation: The Jefferson County Comprehensive Plan Land Use Map designates
the site as Rural Residential 1:10 (RR1:10).
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004
Site Visit: DCD project planner Michelle Farfan conducted a site visit on June 11, 2020.
State Environmental Policy Act (SEPA): The project is exempt from SEPA review under WAC 197-11-
800(6)(d) Land Use Decisions.
APPLICATION NOTICE
Public Notice was published in the Port Townsend -Jefferson County Leader newspaper:
• Notice of Type II Application: May 27, 2020.
Notice was posted on the property:
• Notice of Type II Application: May 21, 2020.
The applicant, the project representative, and all property owners within 300 feet were notified by
mail:
• Notice of Type II Application mailed: May 20, 2020.
Relevant Agencies
Notice of Type II Application, permit application with the survey maps mailed or routed: May 20, 2020,
to the following agencies:
• East Jefferson Fire & Rescue (FD 1)
• Jefferson County Public Works
• Chimacum School District #49
• Jefferson County Public Works
• Jefferson County Assessor
Public Comments: No public comments were submitted.
• Jefferson County Sheriff
• BOCC
• Peninsula Daily News
• Jefferson County -Port Townsend Leader
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB2"
Agency Comments:
DCD received comments (hereby incorporated by reference) from the following agencies:
• Jefferson County Health Department (Septic and Water): Written comments dated July 1, 2020,
from Susan Porto requesting well testing, a protective covenant for the 100' well radius, and all
water lines to be shown on the face of the plat. Written comments dated September 17, 2020,
from Randy Marx, stated that the OSS team has signed off on review.
• Jefferson County Sheriff's Office: Written comments dated May 22, 2020, stating JCSO has no
concerns with the application.
• East Jefferson Fire & Rescue: Written comments dated June 1, 2020, stating EJFR has no issues
with the subdivision.
• Jefferson County Public Works (roads and access): Verbal comments from John Fleming stating
existing access.
• Jefferson County Assessor's Office (legal descriptions): Written comments dated June 8, 2020,
from Kevin Hitchcock and Sherrie Shold requesting clarification on description errors, name
revision, and plat features.
Public Hearing: Type II administrative decisions shall become final subject to the following: an applicant
or party of record may appeal the decision to the hearing examiner for an open record hearing, as
further outlined in JCC Section 18.40.330 & JCC Section 18.40.280. A public hearing will only be held if
the administrator's decision is appealed consistent with JCC 18.40.330(5) within 14 calendar days after
the notice of the decision is issued.
STAFF FINDINGS
Jefferson County Comprehensive Plan: The proposal is subject to all applicable sections of the Jefferson
County Comprehensive Plan ("Comprehensive Plan").
1. The following goals and policies of the Comprehensive Plan apply to the project, which relates to
land use compatibility, transportation, and environmental quality:
Land use: The parcel is 22.81-acres and zoned Rural Residential one dwelling per ten acres (RR 1:10).
Egg & I Road is the nearest county local access road (C516009). The majority of the interior roads
are private with road maintenance agreements as most of the surrounding property has been
previously subdivided. The lots will be served by individual on -site septic systems and individual
wells. Proposed Lot 1 has an existing residence and infrastructure. Proposed Lot 2 has a finaled
septic permit (SEP19-00205) as of December 20, 2019. A new single-family residential permit was
approved on July 29, 2020, and the well is complete with Tag #BKZ795. Bishop Hill Road is private
(P016). Access to Lot 2 is via the existing private access (Bishop Hill Road, AFN 372681) with a
proposed 30-foot-wide ingress, egress, and utility easement for the benefit of Lot 1.
On the proposed Lot 1, the mapped landslide hazard area is heavily treed and vegetated. Elevations
range from approximately 393 feet in elevation at the north boundary just before the clearing to
397 feet in elevation at the southern boundary just before the clearing. The provided survey
identifies the 30-foot landslide hazard area buffer and its 5-foot building setback. There are no
county -dedicated trails within the parcel. However, in Jefferson County, recreational opportunities
are abundant.
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004 Page 4 of 15
The proposal is consistent with the Comprehensive Plan Policies LU P-1.9, LU P-6.1, LU P-10.1, LU P-
15.1, LU P-20.5, and LU P-22.2.3.
Transportation: Jefferson Transit currently does not have a transit stop on Egg and I Road according
to their revised Covid-19 schedule for 2020. Egg and I Road is not required to have any
improvement nor is Bishop Hill Road. The proposed subdivision is increasing the ADT by
approximately 10 trips per day as the house on Lot 1 is already existing. Children housed within the
Chimacum School District will be bussed to the school campus. The proposal is consistent with the
Comprehensive Plan Policies TR-P-1.5, TR-P-2.5, TR-P-4.2, and TR-P-4.9.
Environmental Quality: The proposed short plat is located outside of stream and fish and wildlife
habitat conservation areas and their associated buffers. Slight/moderate landslide hazard area is
the only critical area identified on the property. The owner and surveyor have acknowledged it by
graphically portraying the 30-foot landslide hazard area buffer and its 5-foot building setback to it.
Each lot is served by an individual on -site well and an individual on -site septic system. Because no
road improvements are required, stormwater was reviewed for the single-family residence being
constructed on Lot 2. All stormwater will be retained on -site due to the location of infrastructure,
topography, and size of parcels. The proposal is consistent with the Comprehensive Plan Policies
EN-P-1.1 and EN-P-2.2
Jefferson County Code: The proposal is subject to all applicable sections of the Jefferson County Code.
2. JCC 18.30.030, water supplies: Each lot is served by an individual on -site well. Water quality and
quantity information on each potable well was submitted, reviewed, and approved by
Environmental Public Health.
The applicant has verified that the "irrigation" well (on lot 1) and the "potable" (on lot 1) do not
have a cross -connection and that there is a physical disconnection between the two. The water lines
from the irrigation well on the plat are graphically portrayed and labeled potable lines vs irrigation
lines. A Protective Covenant has been recorded under AFN 640166 for the portion of the 100-foot
well radius that encumbers adjacent properties. The proposal meets this criterion.
3. JCC 18.30.040, sewage disposal: Both proposed lots have existing permitted and finaled septic
systems. The Environmental Health sanitarian signed off on the proposal via email dated
September 17, 2020. The proposal meets this criterion.
4. JCC 18.30.050, density & dimension: Each proposed lot is over 10 acres; therefore, the proposal
meets the required density of RR 1:10 and the dimension. The proposal meets this criterion.
S. JCC 18.30.080, roads: Egg and I Road does not require any improvements. Bishop Hill Road is a
private 40-foot wide easement that serves Lot 2 and surrounding adjacent parcels; it was recorded
under AFN 372681. There is a proposed 30-foot-wide ingress, egress, and utility easement that
comes off of Bishop Hill Road to the west for the benefit of Lot 1 existing house. for Proposed Lot 2.
No road improvements are required. The proposal meets this criterion.
6. JCC 18.35.130 Short plat approval criteria
(1) 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:
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004 Page 5 of 15
(a) 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:
Staff Answer: See Findings 1, 2, and 3 above. The proposal meets this criterion.
(ii) The provisions of this code, including any incorporated standards;
(b) 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;
Staff Answer: See Findings 1, 2, 3, and 5 above. The proposal would require children to
be bussed to and from school due to distance to the nearest school (Chimacum School
District #49), therefore sidewalks are not required. Jefferson Transit currently does not
have a transit stop at this location or on Egg and I Road according to the updated Covid-
19 2020 schedule. Each lot is served by an individual on -site well. Public Works does
not require any road improvements and the East Jefferson Fire & Rescue did not require
any fire apparatus improvements. There are no drainage ways on or near the parcel;
however, Lot 2 has been permitted with a single-family residence, and stormwater was
reviewed at that time in July 2020 and was approved by county staff. Lot 1 is 10.07-
acres and Lot 2 is 12.74.
(c) 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.
Staff Answer: Approving this short plat will serve the public use and interest as each lot is
now developed providing one additional housing unit in Jefferson County and meets the
Comprehensive Plan Density of RR 1:10. Public health, safety, and general welfare will not
be compromised as a result of this short plat. Each lot has been fully developed with the
construction of a single-family residence, on -site wells, and installed, approved, and finaled
septic systems. Roads are installed as the private access easement off of Bishop Hill Road
already serves the development on Lot 1. Jefferson Transit currently does not serve the site
and children attending the Chimacum School District #49 will be bused to and from school.
The proposal meets this criterion.
(2) Notwithstanding the approval criteria outlined in subsection (1) of this section, in accordance
with RCW 58.17.120, as now adopted and hereafter amended, a proposed subdivision may be
denied because of flood, inundation, or swamp conditions. Where any portion of the proposed short
subdivision lies within both a flood control zone, as specified by Chapter 86.16 RCW, and either the
100-year floodplain or the regulatory floodway, the county shall not approve the preliminary short
plat unless:
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-000341SUB20-00004 Page 6 cat 15
(a) The applicant has demonstrated to the satisfaction of the administrator that no feasible
alternative exists to locating lots and building envelopes within the 100-year floodplain; and
(b) It imposes a condition requiring the applicant to comply with Article VI-F of Chapter 18.15
JCC and any written recommendations of the Washington State Department of Ecology. In such
cases, the county shall issue no development permit associated with the proposed short
subdivision until flood control problems have been resolved. [Ord. 8-06 § 1]
Staff Answer: The proposed short plat is not located within a flood plain, floodway,
wetland, or any associated buffers. The proposal meets this criterion.
7. JCC 18.35.190, final short plat
(1) In cases where any restrictive deed covenants or CC&Rs will apply to lots or parcels within a
subdivision, a typewritten 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 before final plat approval.
Staff Answer: CC&Rs were not proposed in conjunction with this short plat.
(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 of trust or mortgages) or any other encumbrances affecting the title of said
parcel. Such individuals or corporations shall sign and approve the final plat before 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
the 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. 8-06 § 11
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-0006--
Staff Answer: An updated Plat Certificate has been submitted. All easements of record have
been identified on the face of the mylar. No bonds or road improvements are required.
STAFF CONDITIONS
Based on the preceding findings, the application as proposed has satisfied the above criteria. Staff
recommends Approval with Conditions of the Type II Short Plat application SUB20-00004. The following
conditions of approval are recommended by county staff:
Main Condition: This preliminary approval is for a Two Lot Short Plat only. Final approval is subject to all
conditions and review by County Commissioners. Any future permits on this site are subject to review
for consistency with applicable codes and ordinances and does not preclude review and conditions
which may be placed on future permits.
Assessor's Office
1. Add the county -assigned case numbers of MLA20-00034 / SUB20-00004 to the upper right-hand
corner of each sheet.
2. The name of the short plat will need to be changed to "LSB Short Plat" as there are already several
"Bishop" plats.
3. Description errors noted:
a) The 8tn paragraph of the description that starts as Thence N89*49'49" W the footage according
to the survey is 658.71 feet.
4. This parcel is a portion of Lot 4 Bishop Short Plat, as recorded in Volume 1 of Short Plats, page 93...
please include it in the description.
Environmental Health Department (Water)
5. Water quality and quantity information on each potable well must be submitted. Quality must be
established by submitting a well log. All three wells need to have water quality samples done for
bacteria, nitrate, and chloride. The two potable water wells have been tested for bacteria and
nitrate only. Water quality test results for bacteria, nitrate, and chloride must be submitted that are
less than 3 years old.
6. Place the note at the irrigation well "hose bib only/no water lines" on the face of the survey.
7. Please clarify how the irrigation well and the potable source on proposed Lot 1 is plumbed and
verify there is no cross -connection between the two sources and there is a physical disconnection
between the two.
8. Is the irrigation well also being used by the northerly adjoining parcel or is it just potable water?
Show the water lines from the irrigation well on the plat, and label potable lines vs irrigation lines.
9. Prior to final plat approval, a Protective Covenant shall be recorded for any portion of the 100'
radius that encumbers adjacent properties. Recorded AFN numbers shall be referenced on the face
of the final plat. The form recorded had errors. The NTT needs to be complete and correct parcel
numbers verified. The NTT must be re -recorded as a correction after review from Environmental
Health. When the notice to title is corrected and re -recorded, a note must be placed associated with
the well on Lot 2 that states "Notice to title for Protective Radius recorded under AFN# ".
Environmental Health Department (Septic)
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004 Page 8 of 15
10. No further information is required as each septic has been finaled with designated reserve
drainfields.
Department of Public Works/EJRF
11. Written comments were not provided by the PWD as the roads are private with road maintenance
agreements for Bishop Hill Rod and Bishop Hill Circle and are existing. A 30-foot wide private
easement exists off of Bishop Hill Road across Lot 2 (east/west) that currently serves an existing
single-family residence. An email dated June 1, 2020, from Brian Tracer, Assistant Fire Chief (EFJR)
stated "I don't see any issues"
Department of Community Development
12. Based on the requirements of Chapter 18.35 JCC Final Short Plat, the final mylar shall be prepared in
accordance with the final short plat checklist located in JCC 18.35.
13. An accurate vicinity map shall be graphically portrayed on the face of the final plat.
14. The final blueline shall depict the name of the subdivision "LSB Short Plat" and the county assigned
number of MLA20-00034/SUB20-00004 on all sheets of the mylar.
15. The existing legal description as described in the updated plat certificate shall be referenced on the
face of the final mylar.
16. An updated plat certificate or supplement shall be submitted with the final blueline and shall be 30
days current.
17. Submit the lot closure information with the final bluelines and updated plat certificate.
18. On Sheet 2, identify the acreages for Lot 2; both sides of the road.
19. 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. 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.
20. All graphics shall meet the recording requirements for legibility.
21. Consistent with RCW 84.56.345, current year and, if applicable, all delinquent property taxes
including compensating tax from open space program shall be paid in full prior to the Treasurer
signing the mylar and paper copies of the short plat.
22. The applicant must submit a reproducible copy (11" x 17") plus seven (7) paper copies of the
proposed final short plat to the Department of Community Development. The proposed final short
plat 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 18.35.3701CC.
23. All signatures and seals shall be in black ink on Mylar.
24. Deeds of Trust as identified in the plat certificate shall sign and approve the final mylar prior to final
mylar recording.
25. The proponent may enter into a surety agreement with the Department of Public Works prior to
final plat approval as an alternative to completing the installation of required improvements. The
surety shall not be accepted for the development of water supply facilities, other than distribution
facilities. The surety shall be for an amount equal to 200 percent of the cost of required
improvements, shall not exceed a period of one year, and must be in a form acceptable to Jefferson
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004 = 9 & ' 5
County. Acceptable forms of surety include bonds, open account agreements, and irrevocable
letters of credit. The surety must be accompanied by an estimate of the cost of all improvements
prepared by a licensed engineer. The estimate shall be approved by the Public Works Department
before acceptance.
26. The following shall be placed 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 the 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 for.
Landslide Hazard Areas and their associated 30-buffers shall remain naturally vegetated. No
alterations shall be made to the Landslide Hazard Area or its associated buffer without prior
authorization by the UDC Administrator. If any inadvertent alteration of the buffer occurs during
the implementation of the approved project, the project proponent shall contact DCD to discuss
mitigation measures to be reviewed for approval by DCD.
Permanent physical separation of the landslide hazard area buffer area shall be installed and
permanently maintained. The buffer shall be maintained in a natural condition.
An additional setback of five (5) is required from the edge of the 30-foot landslide hazard area
buffer to any future proposed development.
NOTICE: The sale of lots prior to final short plat approval is unlawful.
EXPIRATION: Preliminary approval will expire on December 7, 2023. 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, submitting the recording fee for the final plat, and supplying an updated plat
certificate (dated within 30 days of submittal). Requirements are outlined in the final short plat
checklist.
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;
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004 Page 10 of 15
(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 1CC 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;
(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;
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-000341SUB20-00004 Page 11 of 15
(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);
(j) 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)]
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;
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004 Page 12 of 15
(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.
(2) 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)]
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;
(j) 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;
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004 Page 13 of 15
(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 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
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004 Page 14 of 15
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.
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
Jefferson County Assessor
Attest:
Deputy Jefferson County Assessor
day of , 20_
(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.
(z) All signatures or certifications appearing on a final plat shall in be reproducible black ink. [Ord.
11-00 § 7.4(11)]
Date: December 7, 2020
Author: Shannen Cartmel, Associate Planner
Loren Bishop & Linda Lopeman
Bishop Short Plat MLA20-00034/SUB20-00004
m
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street, Port Townsend, WA 98368
Tel: 360.379.4450 1 Fax: 360.379.4451
Web: weti-u.coJefferson.wa.us/communitvdevelopment
E-mail: dcd ( coJefferson.wa.us
PERMIT APPLICATION; �-. R0�
D
Steps in the Permit Process:"
-Review application checklist to ensure all information is completed prior to submitting applieatioa',
-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. Additional fees may apply after review and payment is required before permit is issued.
For Department Use Only Building Permit
Related Application #s MLA #
Site Information
Assessor Tax Parcel Number: 901-353-013
Site Address and/or Directions to Property:223 BISHOP HILL RD., CHIMACUM, WA 98325
Access (name of street(s)) from which access will be gained:
BISHOP HILL RD.
Present use of property: RESIDENTIAL
Description of Work (include proposed uses): 2 LOT SHORT PLAT
Wastewater • Sewage Disposal
This property is served by Port Townsend or Port Ludlow sewer system? YES NO
If not served by sewer identified above, identify type of septic system below:
Type of Sewage System Serving Property:
Septic Septic Permit #: SEP19-00205
Community Septic Name of System: Case #:
Are other residences connected to the septic system?
Additions or repairs to sewage system:
Is it a complete or partial system installation: Complete Partial
Has a reserve drainfield been designated? Yes No
Date of Last Operations & Maintenance check: Attach last report to application
Describe or attach any drainfield easements, covenants or notices on title, which may impact the property:
11
&L4. Co Z.G>'J/(0r'/fa_-\J — ee\ �� iv�U LOG ITEM
2� Page of
Pcmin :Arrticaaon PaL,c
(b S- 00 55-Z`:�� 0� C, 1
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
application. It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts Countv email (i.e..
t-UUr]Ly erndll Is not VIOCKeo or sent Io -- unK malr" .
Applicant/Property Owner Information
Property Owner:
Name: LOREN E. BISHOP
Address: 213 BISHOP HILL RD., CHIMACUM, WA 98325
Phone #: E-mail Address:'
Please contact Authorized Agent/Representative with project info.
Property Owner Signature:
(select only one).
-Date:
Note: For projects with multiple owners, attach a separate sheet with each owner(s) information and signatures.
Applicant: Authorized Agent/Representative (if otherthan owner)
Name:
Address:
Phone #: E-mail Address:
Professional: - 1s this an Authorized Agent/Representative for this project?
NO YES
Engineer Architect Surveyor _' Contractor
Name: CLARK LAND OFFICE License #
Address: PO BOX 2199, SEQUIM, WA 98382
Consultant _
Phone #: 360-681-2161 E-mail Address: INFO@CLARKLAND.COM
Professional: Is this an Authorized Agent/Representative for this project?
NO YES
Engineer Architect Surveyor Contractor
Name: License #
Address:
Consultant
Phone #: E-mail Address:
Professional: Is this an Authorized Agent/Representative for this project?
NO YES
Engineer Architect Surveyor Contractor
Name: License #
Address:
Phone #: E-mail Address:
Consultant
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.
I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with
all applicable federal, state and county laws and regulations and I 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. Applicant may
request notice of the County's intent to enter upon the property for visits related to this application and subsequent permit issuance.
Signature: Print Name: Date: e2
LOG ITEM
OLAZ-(m Page .tea of
This 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
application. It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County email (i.e.,
County email is not blocked or sent to "junk mail").
Applicant/Property Owner Information
Property Owner:
Name: LINDA D. LOPEMAN
Address: 213 BISHOP HILL RD., CHIMACUM, WA 98325
Phone #: —3/ / — �' E-mail Address: azz
Please contact uthorized Agent/Repre ntative with project info. (select only one).
Property Owner Signature: Date:
Note: For projects with multiple owners, attach a separate sheet with each owner(s) information and signatures.
Applicant: Authorized Agent/Representative (If other than owner)
Name:
Address:
Phone #: E-mail Address:
Professional: Is this an Authorized Agent/Representative for this project? NO YES
Engineer Architect Surveyor � Contractor Consultant
Name: CLARK LAND OFFICE License #
Address: PO BOX 2199, SEQUIM, WA 98382
Phone #: 360-681-2161 E-mail Address: INFO@CLARKLAND.COM
Professional: Is this an Authorized Agent/Representative for this project? NO YES
Engineer Architect Surveyor Contractor Consultant
Name: License #
Address:
Phone #: E-mail Address:
Professional: Is this an Authorized Agent/Representative for this project? NO YES
Engineer Architect Surveyor Contractor Consultant
Name: License #
Address:
Phone #: E-mail Address:
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.
I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with
all applicable federal, state and county laws and regulations and I 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. Applicant may
request notice of the County's intent to enter upon the property for visits related to this application
//and subsequent permit issuance.
Signature: �r Print Name: Date:
L JG ITEM
Page S, Of -,�--
f
ON C'O
4� �� DEPARTMENT OF COMMUNITY DEVELOPMENT
W J 621 Sheridan Street, Port Townsend, WA 98368
Tel: 360.379.4450 1 Fax: 360.379.4451
Web: ww-w.co.jefferson.wa-us/commLiniiydevelopmeiit
ING"0 E-mail: dcd ,co.jefferson.wa.us
SUPPLEMENTAL APPLICATION
LAND DIVISIONS , 20,0
� #/ )PROJECT/APPLICANT NAME: k�;1
Submittal Requirements
1. A completed Permit Application and State Environmental Policy Act (SEPA) Checklist (if applicable).
Representative authorization is required if application is not signed by owner.
2. Short Plat, Long Plat or Binding Site Plan application fee (as applicable), as set forth in the Jefferson County
Fee Ordinance, as amended.
3. Any supplemental information identified by the Administrator.
4. Certificate of Water Supply Utility Service Form.
5. Five (5) paper copies of a preliminary plat meeting the requirements of Jefferson County Code (JCC)
18.35.110 and 18.35.120 for short plats, or JCC 18.35.290 and 18,35.300 for long subdivisions/binding site
plans and identifying points of access, all easements, deeds, restrictions, or other encumbrances restricting
the use of the property, as applicable. Copies of the applicable JCC sections are attached for your use.
6. Where site conditions require a special report to assess or address any probable significant adverse
environmental impacts, a study (or studies, as applicable) prepared by a competent professional may be
required if deemed necessary by the Administrator.
7. Evidence of compliance with JCC 18.30.070, Stormwater Management Standards, as deemed necessary by
the Administrator.
8. The preliminary plat must be prepared in accordance with JCC 18.35.110 for short plats, or 18.35.290 for
long plats. The contents of the preliminary plat must provide the information listed in 18.35.120 for short
plats and 18.35.300 for long plats.
9. The following supplemental information.
ubdivision Name:
Land Use (check one):
Industrial
® Residential ❑ Commercial ❑
Total Acreage of Property:
22.81 AC. Total Lots Proposed: 2
Water Supply (check one):
® Individual Wells ❑ Community Water System
Sewage Disposal -Method:
SEPTIC
Average Lot Size: 11.40 AC
Minimum Lot Size: 10,06 AC Open Space:
9" 4
Page 1
10. I, , do hereby swear and certify that in addition to the land
subject to this application (check the box below which applies):
❑ 1 have no interest in
❑ I have an interest in
land within 300 feet of any portion of the subject property by reason of ownership, contract for purchase by
agreement or option by any person, family member, firm, or corporation in any manner connected with me or
the development.
SIGNATURE
DATE
11. The applicant hereby certifies that the preliminary plat provides an accurate representation of the proposed
land division; and the applicant hereby acknowledges that any approval issued on this application may be
revoked if any such statement is found to be false.
SIGNATURE DATE
Page 2
Jefferson County Health Department fmw" 3
615 Sheridan SU f )O— 0Gj MAR - 5 2020
Port Townsend, WA 98368
(360) 385-9444
JEFFERSON COUNTY ENVIRONMENTAL HEALTH
SUBDIVISION REVIEW APPLICATION
Type (check): Short Plat Long Plat Other (specify)
Applicant Name: 0 re'n , s��►�
Address: �, I
01 of
// /001
Receipt #
Check #
Fee
Date
OTH
Telephone: �� _, ' %'/ 7 — jam' 7 �% E-mail Address: Zo , e o �J r P�� 1' �,`c / / le , con
Authorized Representative: .S" M 1�
Address:
Telephone:
E-mail Address:
PROPERTY DESCRIPTION
Legal Description: Section _sue Township Range I UV
Parcel Number: Q® ( 353 013
Subdivision Name (if known):
# of lots Average lot size
WATER SUPPLY SOURCE (check): Individual Well
Public (specify)
Extension of existing system:
Minimum lot size
Community Well
Previous Evaluation by Health Department Yes No Date of Evaluation:
Previous Owner (if known):
NEED AT LEAST 4 SOIL TEST PITS PER LOT. ATTACH A COPY OF SOILS REPORT PREPARED BY A
PROFESSIONAL ENGINEER OR A LICENSED SEPTIC DESIGNER, AND A PLOT PLAN SHOWING THE LOCATION
OF THE TEST HOLES.
This evaluation does not constitute a guarantee of approval of an on -site sewage disposal permit.
LOG ITEM16
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