HomeMy WebLinkAboutXMP1989-00020xmP8q -oozoJr
n JEFFERSON COUNTY —CITY OF PORT TOWNSEND
SHORELINE SUBSTANTIAL DEVELOPMENT PERMIT
EXEMPTION APPLICATION
The Jefferson -Port Townsend t�horeUnerManagementsnt Master
Proggratfieexempts
certain deveLopments from pg n To uathe for
Washington State ShoreL ine Management Act (RCIJ 90 .58) . q y
an exemption, the proposaL must be reviewed and approved by the
Jefferson County PLannLng and BuU dLng Department.
Answer the foLLowing questions compLeteLy. Print in ink or type the
answers.
APPL 1 CANT :�-
ADDRESS: �{37 `. [�➢S u c� P . r3 iv8
TELEPHONE: ( home) 3 ff S - _? 3 (o
(business) b°l7'97af
REPRESENTATIVE (contact): ff�1U`C%
ADDRESS: fi �_7,1 S
t��0. ns • � q�3��
TELEPHONE: ( home) 2 v <- ` 3C. g
(business) (n�7-9 701
PROPERTY DESCRIPTION
�
GENEPAL LOCATION: LvT S IA T
v1= ,CGeAc14
� P�
✓d--9A4_
LEGAL(s) (identify each offected nrestywLth upl,andLnformatLon property iffp�oposaL is
property tax statement--describeea
within a waterbody):
e ❑ Proposal, Site /C9, UpLand Site
Owner:
Address: S. lei owe
Tax ParceL Number: 7.2 !o ?2 60y - op.S
Real, Property Description:
e ❑ ProposaL Site ❑ UpLand Site
Owner:
Address:
Tax ParceL Number:
Real, Property Description:
ADJACENT INATERBODY:
kececpt 391gq
�fo�8q
0
PROPOSAL DESCRIPTION
PROPOSED DEVELOPMENT: v Ia
USE (L-A GC -
ESTIMATED COST OR FAIR MARKET VALUE: �(D.S7 s az
COMPLETION DATE: �q
ARMY COPPSPERM IT: ❑ AppLied—Notice Number:
V Not Required ❑ Required --Not AppLLed
STATE FISHERIES -GAME HYDRAULIC PROJECT APPROVAL: ❑ AppLied
Not Required ❑ Required —Not AppLied
SITE PLAN
A site plan must accompany the exemption request. It shaLL be no
Larger than 8% by 11 inches, to scale, and suLtabLe for copying. It
shaLL LLLustrate and identify the foLLowLng features:
• North arrow and scaLe.
• DeveLopment area (property boundary Lines, sectruct res, etc.)
• Property improvements (exLstLng and proposed structures, utilities,
deveLopment, etc.)
• Property features (exLstLng and proposed changes to topography and
ground reLief, vegetation, etc.)
• wlaterbodLes and wetLands.
• Or--dLnary,hLgh or mean higher hLgh water LLne.
ACKNOWLEDGEMENT
I hereby declare that tf-,e LnformatLon provLded Ln thLs appaLcatLon edge
true and correct to the best of my knowledge. FurLs
ther, o
may not
r untLL
that ed by then Jeff ersonof the pCountyLPLannLng anduBuLLdLngapproval- has Department. been
granted by the
appLLcant or authorized representative (date
(OFFICE USE ONLY)
CASE NUMBER: FEE: RECEIPT NUMBER:
�pvS•
SC vl L G 1 z S 0'
T_.
r, li
j�I�LAPIL BE.,ac H
H-o 0 0 C 1a IJ x L-
&ov j , L.oT a � SEC T- a
V
A L S