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KITTITAS COUNTY COMMUNITY DEVELOPMENT SERVICES <br />411 N.Ruby St.,Suite 2,Ellensburg,WA 98926 <br />CDS@CO.KITTITAS.WA.US <br />Office (509)962-7506 <br />- <br />¯"Building Partnerships -Building Communities"Fax (509) 962-7682KITTIEthfulNEY <br />LONGPLAT APPLICATION <br />(To divide lot into 5 or more lots,per KCC Title 16) <br />A preapplication conforence is REQUIRED if'proposing more than nine (9)lots per KCC 15A.03.020 for this permit.The <br />more information the County has early in the development process,the easier it is to identify and work through issues and <br />conduct an efficient review. To schedule a preapplication conference, complete and submit a Preapplication Conference <br />Scheduling Form to CDS. Notes or summaries from preapplication conference should be included with this application. <br />Please type or print clearly in ink. Attach additional sheets as necessary.Pursuant to KCC 15A.03.040,a complete <br />application is determinedwithin 28 days of receipt of the application submittal packet and fee.The following items <br />must be attached to the application packet. <br />REQUIRED ATTACHMENTS <br />Eight large copies of plat with all preliminary drawing requirements complete (reference KCC Title 16 Subdivision <br />Code for plat drawingrequirements)and one small 8.5"x 11"copy <br />SEPA Checklist (if not exempt per KCC 15.04 or WAC 197-11-800) <br />o Please pick up a copy of the SEPA Checklist if required) <br />Project Narrative responding to Questions 9-11 on the following pages. <br />OPTIONALATTACHMENTS <br />(Optional at preliminary submittal,but required at the time offinal submittal) <br />Certificate of Title (Title Report) <br />APPLICATIONFEES: <br />$4,460.00 Kittitas County Community Development Services (KCCDS)*Preliminary Plat Fee <br />$1,020.00 Kittitas County Department of Public Works <br />$524.00 Kittitas County Fire Marshal <br />$970.00 Kittitas County Public Health <br />$6,974.00 Total fees due for this application submittal (One check made payable to KCCDS) <br />FOR STAFF USE ONLY <br />Application Received Bj (CQS Staff Signature):o y W <br />DATE:RECEIPT #c <br />DATE STAMP IN BOX <br />COMMUNITY PLANNING •BUILDING INSPECTION •PLAN REVIEW •ADMINISTRATION •PERMIT SERVICES•CODE ENFORCEMENT •FIRE INVESTIGATION <br />FORM LAST REVISED:05-21-2018 <br />Page 1 of 3 <br />Index #3