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Kittitas County Water Mitigation Application Page 5 of 5 <br />FOR OFFICIAL USE ONLY <br />Review oLAmlication <br />Permit #: <br />Application is complete? <br />❑Yes ❑No <br />Full legal description attached? <br />❑Yes LINO <br />Metering agreement attached? <br />❑Yes ❑No <br />Irrigation affidavit attached? <br />❑Yes LINO <br />If well drilled after December 2, 2015, well log included and I W5R construction requirements <br />❑Yes ONO ❑NA <br />met? <br />Applicant Notified? <br />Date of Notification: <br />Notification method: E3 Email <br />❑ Fax ❑ In-Person 13 Phone <br />❑yes❑No <br />Evaluation Notes: <br />Date: Notes: <br />Date: Notes: <br />Final Evaluation: <br />REVIEWER: <br />APPROVAL DATE: <br />❑ Water Mitigation Package A Cost; $3$45 <br />❑Water Mitigation Package B Cost: $4810 <br />13Water Metering 1st year Cost: $180 <br />Total Fee Due: $ <br />Receipt #: <br />Kittitas County Water Mitigation Application Page 5 of 5 <br />