Short Subdivision Application

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Short Subdivision Application Powered By Docstoc
					                                               City of Bremerton
                                     Department of Community Development
                                            345 -6th Street, Suite 600
                                          Bremerton, WA 98337-1873
                                                 Phone: (360) 473-5275
                                                  Fax: (360) 473-5278

                    Conditional Use Permit Application
Bremerton Municipal Code 20.58.020

File #                                             Fee:

***Please provide six (6) sets of copies of the application and site plan, legal description of
property, 3 sets of mailing labels (property owners within three hundred feet of the
property), and other relevant information***

Please complete the following application with as much detail as possible about your proposal and submit
it along with the application fee. The application must be complete before any processing can occur.

Project Name

Applicant (grantor):
Address:                                              Phone Number:

Contract Person (if different than applicant):

Address:                                              Phone Number:

Title Holder (if different than applicant):
Address:                                              Phone Number:

Project Representative:
Address:                                              Phone Number:
Conditional Use Permit Application

Project Description (number of buildings, dwelling units, lot area, square footage of buildings, lot
coverage) :


Property Information:

General Location:________________________________________________________________

Tax Assessor’s Parcel Number(s):___________________________________________________

Zoning Designation: ______________________________________________________________

Comprehensive Plan Designation: ___________________________________________________

Parcel Size (property dimensions): ___________________________________________________

Sewage Disposal Method: _________________________________________________________

Water Source: ___________________________________________________________________

Describe the Critical areas (shorelines, creeks, lakes, wetlands, slopes over 25%) on-site:



Total Disturbed Area:______________________             Earthwork Grading Quantity:____________________

Forest Management:

(a)       Has the property been logged in the past six years?

(b)       Forest Practices Application No:

Bremerton Municipal Code 20.58.020 Criteria of Approval:

      Please provide as much detail as appropriate to support this application.

      1. Is the proposal consistent with the City’s Comprehensive Plan goals and policies?

      2. Will the use comply with all applicable zoning and development standards and requirements
         including the availability of all needed utilities and services?

      3. Will the proposal, along with any mitigation measures or other conditions of approval, avoid
         significant adverse environmental consequences?

      4. Will the proposal be compatible with adjacent uses and surrounding neighborhood?

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Conditional Use Permit Application

Please provide below (or on a separate paper) detailed explanations or other information that will assist in
the review of your request and that will help show that your proposal meets the above criteria.




                                         Signature Statement
OWNERS: The owner(s) whose signatures appear below certify that they are the legal owners of the
property encompassed by this Residential Cluster Development and approve of this division.

                                 Signature: _______________________________

                                 Printed Name:

State of Washington )
                      ) SS
County of Kitsap     )

On this        day of        ,      , before me, the undersigned, a Notary Public in and for the State of
Washington, duly commissioned and sworn, personally appeared              , to me known to be the individual
described in and who executed the within and foregoing instrument, and acknowledged that
signed the same as         free and voluntary act and deed, for the uses and purposes therein mentioned, and
on oath stated that he/she was authorized to execute said instrument.

______________________, ___________.

                                                          Notary Public in and for the State of Washington,
                                                          Residing at ________________________.

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