HomeMy WebLinkAboutZON1999-00023 ck____9_,G
rctAiN )
2 5 loco
JEFFERSON COUNTY PERMIT CENTER
621 SHERIDAN ST., PORT TOWNSEND, WA 9836 .11
13601 379-4450 1-800-831-2678
SIGN PERMIT APPLICATION
# ZON9q- zaf.;1
z9• .-
Applicant: ME I/ER '5141 CO. (NM•
Mailing Address: po (6x 337'3 S 77LE WA 9$113
Phone: (Home) 206 b24 4243 (Work) Zob Gz${ gag3
Location of Proposed Sign:
Street Address of Building: /l CG Z RHpQN DA
Legal Description: (Available from the County Assessor's Office)
Nine Digit Parcel Identification Number: 4995i ZUp OS g
Section: Township: Range:
Subdivision: Block: Lot(s):
Are there any signs currently on site? rES If yes, list type, dimensions, sq. ft. of sign area, location.
Type: ft E Dimensions: Sign Area (sq. ft.): Exig Location: N W (AQNER QF LUT
Type: w1L(_ Dimensions:Sty 5c Sign Area (sq. ft.): ice? Location: 5eu1H ELEVA-TIUII
Type: CA,Kkipt/ Dimensions: 60i Sign Area (sq. ft.): 4& Location: p
List proposed signs f✓44 • 6O"Nfg=ld�� = 9�,/b , RE-Maki
���to�BoQF : 2=3i1X ''�'-`uV
Type: Dimensi Sign Area (sq. ft.): Location:
//
Applicant's Signature: Date: b 2/
Owner's Signature: Date: t; 2 i 9,
(If other than applicant
FOR OFFICE USE ONLY
APPLICATION FEE: ZcS` RECEIPT #: 1(00
DATE: - % CHECK #: 61;14 Z.
' INITIALS: t "�
�� 1.4)�
Jefferscna County Permit Center Date
y21 Sheridan Street Fee
Port Townsend WA 98368 Rec #
CRITICAL AREAS QUESTIONNAIRE Ck #
Case #
Applicant Name
Building Application Land Use Application Shoreline Application
On-site Sewage Application Subdivision Application Other:
1 . Is there any standing or running water on the surface of the YES NO
property or on any nearby property at any time during the year?
If YES, please describe:
r l
2. Has any portion of the property or any nearby property ever been YES\; , NO
identified as a wetland or swamp?
If YES, please describe:
3. Are any willows, skunk cabbage, alders, or cottonwoods present \YES NO
on your property or adjacent properties?
If YES, please describe:
✓r✓1L Vn FT -rioJcl rzUS S pFt-G g n�
4. Are there any indications on any portion of the property or on any YES XN0
nearby property of rockslides, earthflows, mudflows, or landslides?
If YES, please describe:
5. Please indicate which line best represents the steepest slope found
on your property. (Check appropriate box)
/ / / / / / /• 'I
! / / / / / /
/ / / / / / /
/ / / / / / /
/ / / / / / /
/ / / / / / / /
/ / / / / / / /
! / / / / / /
/ / / / / / / L
/ / / / / / / / •
/ / / / / / / / //
! / / / / / / / / /.L2J --w•-
/ / / / / / /
! / / / / / / / / / r
l / / / / / / / �... _...__
/// / C7
/////// / / //
--
A'% � (Questionnaire Continues on Back)
6. Does the site have steep slopes with little to no vegetation? YES NO,-
If YES, please describe:
7. Does the site contain high percentages of silt and/or very fine YES °, NO
sand?
If YES, please describe:
8. Does the site contain ground water seepage or springs near the YES "`. NO
surface of the ground? v
If YES, please describe:
The applicant hereby certifies that all of the above statements and the information contained in any other
transmittals made herewith are true, and the applicant acknowledges that any action taken by Jefferson
County based in whole or in part on this application may be reversed if it develops that any such statement
or other information contained herein is false.
Signature Date 6
FOR OFFICE USE ONLY
❑ Wetlands ❑ Seismic
CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1
IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area ❑ Fish & Wildlife Area 2
❑ Erosion
❑ Landslide
Zone:
Parcel Size: Status:
Comprehensive Plan Land Use Designation: Reviewed by:
Community Plan: Date:
a'. t tx t
1TMJ/ T S
�'z,: -a r tar .a y.'` f`$, 4
m.A 1 pip YTTT �3s p '�' r #'� "'k t.rs�, r _ ' .
Aga fi
lr x{ ;lilt:
rk } �� p
& .Li.. .tiyd- k4 , � t .t F 3� �'fi �2 �, Y^F�
•
S21�' M1 .37.D`Y ky J f7
j .. ...i..1.•;-.1.,„ f.* ,--;.,-...,,.•,,,.:;,-.. ,-, k •-.. ..:-.. -•••.•• .•:: •'• .
d.^n+ d y.
trk`
r � 4 1
# way t }�. p
/ .. . .. .. ,
s.tcp
,q} , . r7 -1
, ...,, ...
. .
. . . . . . . .. . ,.
4, fs r I t
I
r l
--1
r— •
•
}=
1 r . ,,,,
•
•
. .
,. A, ''' ,, „.
..,... ,., , . . . i
,, .
4 Nd
s
,
•
. .
. .
. ,.....
•.• , .
. ,. . •,t.„,,„/„. t
. 1,. .
•
4,04...1, .
j
. .
. .
. . 1„„il.,,..„.•..„:, „„
�. , .,