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s x hi b (A i -i <br />KITTITAS COUNTY COMMUNITY DEVELOPMENT SERVICES <br />-. 411 N. Ruby St., Suite 2, Ellensburg, WA 98926 <br />CDSQ)..CO.KITTITAS_N'A.I;S <br />Office (509) 962-7506 <br />Fax (509) 962-7682 <br />Stl77TIaS COL'.YIS' !{ 1 . - <br />� <br />;'�;:c1 ',� w'^7 'm:. !�-+ ^�-s*" n27Sik'vap, a..�, x'+`fi•-"Y" d%-- } +".�'..,-os.%=}..•,r,�a <br />LONG PLAT APP LICATI®N <br />(To divide lot into S or more lots) <br />KITTITAS COUNTY ENCOURAGES THE USE OF PRE -APPLICATION MEETINGS. PLEASE CALL THE DEPARTMENT IF YOU WOULD LIKE TO <br />SET UP A MEETING TO DISCUSS YOUR PROJECT. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. <br />PLEASE TYPE OR PRINT CLEARLY IN INK. ATTACH ADDITIONAL SHEETS AS NECESSARY. THE FOLLOWING ITEMS MUST BE <br />ATTACHED TO THIS APPLICATION PACKET: <br />REOUIRED ATTACHMENTS <br />Ten large copies of plat with all preliminary drawing requirements complete (reference KCC Title 16 Subdivision <br />Code for plat drawing requirements) and one small 8.5" x 11" copy <br />Address list of all landowners within 300 feet of the site's tax parcel. if adjoining parcels are owned by the applicant, <br />the 300 feet extends from the farthest parcel. If the parcel is within a subdivision with a Homeowners or Road <br />Association, please include the address of the association. <br />E] SEPA Checklist (Only required if your subdivision consists of 9 lots or more. <br />Please pick up a copy of the Checklist if required) <br />OPTIONAL ATTACHMENTS <br />(Optional at preliminary submittal, but required at the time of final submittal) <br />❑ Certificate of Title (Title Report) <br />❑ Computer lot closures <br />FEES: <br />$200 plus $10 per lot for Public Works Department; <br />$625 plus $75 per hour over 12.5 hours for Environmental Health Department; <br />$1500 for Community Development Services Department, PLUS $225 if SEPA Checklist is required <br />*One check made payable to KCCDS <br />FOR STAFF USE ONLY <br />I CERTIFY THAT I R$CENED T- APPI ICAT}i0 <br />Gr<' lr F 3 �- t <br />SIGNATiTIE C x} x, 4i , ,I"i?A1 E a t n RECEII'fi €00 <br />tEji <br />A „ 'E'�... �d ry '' <br />•zr'�Y ice" ((fi�n <br />L V 4! � <br />,r <br />r�r1C.• <br />>v� rd: <br />,_.s ,.:_:�-_.: .y.,v:„kp..:•�. 6,.r-...E:.�.;.^ <:_a«....,. .. .a .,....:r.:i:: E\i f 1 t f �'. <br />(� f c z >e -ti +d u m sA "c' ice',,�-�. 'aAtM r 'Srt -Z -a qi -t y", sa la . [� ('Y <br />NOTE) %'.',;, y -3 7 .i �'4ri, '`ir��a�3 4L': ^ t,v1Vfi+•�1,p, F h, :v C7 1 ^r�s.'i� �' -r' �i �...{ r a, a <br />2o''Z a_. zi C4" ra�. hrckl s ..fi yn^_5^'vgr.,.�tl c "> t>..s.; rxt s~i 1,°�� r•>sjti''F�. <br />w f tl 2r Ft ti l �?g L +r z i; Flu P t <br />- -.,. f.,:: ` P.:4 ...:. L:r:,�'.''i r.'st�:`•..'^ r.._..'=.. _.� . _'s, c _... �`_ Irv.:;. - .,.... ... ...-- -a _. <br />DARRYL PIERCY, DIRECTOR <br />ALLISON KMBALL, ASSISTANT DIRECTOR <br />COMMUNITY PLANNING BUILDING INSPECTION PLAN REVIEW ADMINISTRATION PERMIT SERVICES CODE ENFORCEMENT FIRE INVESTIGATION <br />