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621 Sheridan Street · Port Townsend · Washington 98368
3601379-4450'800/831-2678'360/379-4451 Fax
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PROJECT/APPLICANT NAME: Discovery Bay Planned Rural Residential Development
Submittal Requirements
1, A completed Master Land Use AppUcation and state Environmental Policy Ad. (SEPA) Checklist (If applicable),
Representative authorization is required if appUcation 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
OIdinance, as amendec:f.
3. Any supplemental infonnation identified by the Administrator.
4. Five (5) paper copies of a JRIminaIy plat meeting the requirements of Unified Development Code (UOC) Sections
7.3.3 and 7.3.4 for short plats, or UDC Sections 7.4.3 and 7.4.4 for long subdivisionslbinding site plans and identifying points of access, aU
easements, deeds, restrictions, or other encumbrances restrid.ing the use of the property, as applicable. Copies of the applicable UOC
sed.ions are attached for your use.
5. Where site conditions require a spec/aI report to assess or address any probable significant advelSe environmental
impacts, a study (or studies, as applicable) prepared by a competent professional may be required if deemed necessary by the
Administrator.
6. Evidence of compliance with UDC Section 6.7, stoonwater Management standards, as deemed necessary by the
Administrator.
7. The preliminary plat must be prepared in accordance with UDC Section 7.3.3 for short plats, or 7.4.3 for long plats. The
contents of the preliminary plat must provide the infonnation listed in 7,3.4 for short plats and 7.4.4 for long plats.
8. The foUowing supplemental information:
WaterS
Discovery Bay
X Residential
200:!: Acres
Planned Rural Residential Development
Subdivision Name:
. Industrial
Oi sa! Method:
Average Lot Size: ,97 Acres Minimum Lot Size: .3 Acre
S ce: 1542 Acres
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I See UOC Section 7, Use this apptication for Preliminary Plats (short 01'1009) and for Mixed Use, CommerciaJ and Industrial Binding Site Plans; a
separate application is available' for Residential Binding Bite Plans.
LAND DIVISION APP.DOC REV, 4/3/2001
Page 1
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9,
I, Michael Asmundson, OwnderlManaQer, do hereby swear and certify that in addition to the land subject to
this application (check the box below which apPlies):
X I have no interest in
o I have an interest in
land within 300 feet of any p()rtion 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
SIGNATU~~
DATEq's-~r
10, 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,
SIGNATUR~~
,/S-Ar
DATf: "
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LAND DIVISION APP,DOC REV, 41312001
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