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Home My WebLink AboutRcvd07-08-2019_JCSA_CSFOperatingPermitApplicationDEPARTMENT OF COMMUNITY DEVELOPMENT 621 Shcrid1m Stttet, Pott Townsend, WA 98368 Tel: 360.379.4450 J Fax: 360.379.4451 Web: www.co.jeffecson.wa.us/ communitydevelopmenc E-mail: dcd@oo.jcffcn;on.wn.us ,. COMMERCIAL SHOOTING FACILITY l!J OPERATING PERMIT Process (Article Ill of the Chapter 8.50 Jefferson County Code [JCC]) 1. Submit commercial shooting facility operating permit application as required by JCC 8.50.240 and pay all permit fees required in the JCC Appendix Fee Schedules. 2. The county reviews the application and may request additional information if needed. 3. The county will contract with a qualified shooting range evaluator to conduct a professional evaluation of the proposal and the facility. Per JCC 8.50.240(7}(d), the applicant shall reimburse the county for the actual costs incurred (including consultant work) of the evaluation. No operating permit shall be issued until reimbursement to the county is made. 4. Inspection of the site of the new or established commercial shooting facility by the qualified shooting range evaluator per JCC 8.50.240(7)(a). 5. The OCD director determines whether the commercial shooting facility qualifies for a provisional operating permit per JCC 8.50.230(4)(c). 6. The DCD director issues a notice of the commercial shooting facility operating permit application per JCC 8.50.240(9). 7. Upon conclusion of the noticing period, the county reviews the application, professional evaluation, and public comments, and may request additional information. 8. The county may approve the operating permit. 9. Prior to issuing any operating permit or provisional operating permit, the department inspects the commercial shooting facility to determine compliance with any applicable conditional use provisions required by Title 18 JCC and all the requirements in the approved operating permit application. 10. Annual Report and inspection due to determine compliance with the operating permit. This fee is due with the annual report submittal. See the annual inspection checklist for details. Required Submittal Hems for a Complete Appllcatlon i---,;=-----1 _Permit Application Supplemental Shooting Facility Operating Permit and fees ---Facility design plan -see shooting facility design plan checklist -~t-$~ ,_ _ __, 1---1 Safety plan -see safety plan checklist , __ __, Operations plan -see operations plan checklist 1----1 Professional evaluation acknowledgement -read and sign the professional evaluation agreement 1----1 Notarized Certification -see Operator's Certification Checklist List of all property owners prepared by a title company within the distance of the safety fan, but no less than one mile 1------,1. 1---• Pay All Applicable Permit Fees \ ~ State Environmental Policy Act {SEPA) checklist and/or Envlronmental Impact Statement with SEPA fee (for new or ..,_.._'....:..,.\'~~ expanding facilities only) / Current Septic O & M Report (Operations and Maintenance) (for new or expanding f ll1!es nly) \"2s' Conditional Use Permit Application and Fees (for new or expanding facilities onl ) 1 ,_~--· JUL ·-f: ?0FI JEFFERSON COUNTY oco DEPARTMEN'I' OF COMMUNITY DEVELOPMENT 621 Sheridan Street, Port Town.end, WA 98368 Tel: 360.379.4450 I Fax: 360.379.4451 Web: www.co.jcffc.rson.wa.us/communitydcvclopmcnt E-mail: dcd@co.jcffcnon.w.i.us PERMIT APPLICATION 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 wit h the Permit Technician by calling 360-379-4450. • This Is not a standalone appllcation; It must be accompanied by a project specifrc 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 Related A plication #s: 5~1 Information Building Permit # MLA# Assessor TaK Parcel Number: Occ:> IO B 30 I 2.. -------~~-------------------Site Address and/or Directions to Property: 1/;2 6lw.u.ul3../:?J.~2,....-L.8'5'.11tq.Z-1,J;="'-'AC.:>.-c,::..A,,1LI.,-="------------' Present use of property: c ,'-T ~ Description of Won< (include proposed uses): Wastewater • Sewa.ae Olsnosal (for new or expi ndlna facilities only) This property is served by Port Townsend or Port Ludlow sewer system? YES NO / If not served by sewer Ident ified above, identify type of septic system below: Type of Sewage System Serving Property: 5cm c4~ wtq1-- V' Septic Septic Permit #: S€P o 4--oo-J9,2- Community Septic Name of System: Case#: Are other residences connected to the septic system? N-c Additions or repa irs to sewage system: N o~t: Is it a complete or partial system installation: Complete i/' Partial Has a reserve drainfield been designated? Yes .IL No ~-12..-.2010 Attach last report tc Date of Last Operations & Maintenance check: application Describe or attach any drainfield easements, covenants or notices on title, which may impact the property: 2 DEPART MENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street, Port Townsend, WA 98368 Tel: 360.379.4450 I Fax: 360.379.4451 Web: www.co.jefferson.wa.us/commurutydevclopment E-mail: dcd@co.jeffenon.wa.us SUPlI,EMENTAL APPLICATION COMMERCIAL SHOOTING FACILITY OPERATING PERMIT Tax Parcel Number: 0,.._-0 ( 08.:3012 Is this for a new or expanding shooting faclllty? l'INo [] Yes. If yes, condlllonal use permit application is ,equlted under Title 18 JCC. A pre-appticatlon conference !a a prerequisite to a =rtion,al use permit appllcallon under Title 18 JCC. Are the ehootfng facilftfea indoor or outdoor? Select if any of following types of firing ranges proposed: [] RIii& and/or pistol [] five-stand shooting, skeet shooting, sport clay sl\ooting, andfor trapshooting Does the proposal include exploding targets? l!t' No a Yes. If yes, submit a mitigation plan for noise impacts on neighbors OFFICE USE ONLY Operating Permit Fees Base Fee (23 hours)* $2,162.00 SEPA fee (10 hours) (for new or exoandlng facilities onlv) $~0 Notice ~- Notice Board $~0. Environmental Health -Solid Waste (for new or expanding facilities onM ~ Environmental Health -Potabre Water (for new or expandina facilities only) $~ Professional Evaluation At Cost to the County** Scan Fee $24.00 ·'2.-l g..e Technolo~v Fee -5% \ oq. i.>O Total Fees• zzqs. so Pre-operation Inspection $282.00 due prior to inspection * Additional fees may apply. Review beyond 33 hours will accrue an hourly fee. New or expanded facilities must also obtain a conditional use permit, which requires a separate conditional use permit application and fee submittal . .,The applicant shall reimburse the county for the actual costs incurred (including c'Jf <Clf WJEtj/1 4 JU[_ .. /; ?'· ·1 w JEFFERSON COUNTY oco The authori2ed agent/representative is the primary contact for all project-related questions and correspondence. The County wllt 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., Countv email is not blocked or sent to "iunk mail"\. ( ADDHcant/Prooertv Owner Information Property Owner:_ Name: ..J e.f~~>,..J ~LIT'"< Address: Phone#: E-mail Address: Please contact Authorized Agent/Representative with project info. (select only one). Property Owner Signature: Date: Note: For crolects with multicle owners, attach a seoarate sheet with each ownerlsl information and slanatures. ADoflcant: Authorized Atrent/Reoresentatlve ( If other th1111 owner) l Name: "T')~lo.lA• ·"-\) W'\,c_ ~6:4G.-S ~ Address: "Po ·R.,--,v c:J 7 \ B-....11,· TC>,.,.i 1->~tv(") 1AA , Gi~?,L~ Phone#: 3~Q -7<.'4 -~:1.q l E-mail Address: .~~~~ ~ -vn..c..q G.."> ('f"\ Professional: Is this an Authorized Aaei,t/Rep.resentative for this oroi~ct? NO YES Engineer Architect --Surveyor -Contractor Consultant Name: License# Address: Phone#: E-mail Address: Professional: Is this an Authorized ARent/Representatlve for this oroiect? NO YES Engineer Architect --Surveyor -Contractor Consultant Name: license# Address: Phone#: E-mail Address: Professional: ts this an Authorized Ar.ent/Representative for this orolect? 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 in this application form, 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, repr sentatlves or agents for the sole purpose of application review and any required later inspections. Applicant ~av request notice of he Coduty' intent to enter upon the property for visits related to this application and subsequent permit issuance. L £ . . Signature: ;~ j; Print Name: D~>*-'At,.t'D D Wj,:_1'.J~~ ~ Date: _____ _ 3 ACt<NOWU!DQEMENT By signing the application fonn, the appllcant/owner attests that the Information provided herein is true and correct to the best of their know! ge. Any material falsehood or any omission of a material fact made by the applicant/owner wlth respect to this application acket ma r ult this permit being null and vo,id. -B-2.Df (APPLICANT OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) (NOTE: Representative authorization is required if application is not signed by the Owner.) 5 JEFFERSON COUNTY oco