SHORT PLAT APPLICATION CHECKLIST City of White Salmon. Application completed with notarized signatures

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1 SHORT PLAT APPLICATION CHECKLIST City of White Salmon Application completed with notarized signatures Road Classification as assigned by City Public Works Director City Public Works Director Certification on water and sewer Radius search 2 8 1/2 X11 and (1 full size) copies of Preliminary Short Plat map Vicinity map Short Plat Certificate from title company Notarized signatures of consent of interest holders (if any) Environmental checklist, if required Short Plat $750 plus $30 per lot for Single Family Town House, Multi-family $1,000 plus $30 per lot Please verify the City Public Works Director s recommendations for requirement of the following items: Road/utility plans and profiles, if applicable Drainfield suitability certification if on-site sewer proposed and certified by Klickitat County Health District Date Received at City Hall

2 CITY OF WHITE SALMON SHORT SUBDIVISION APPLICATION APPLICANT (s) Address Telephone Number Represented by GENERAL LEGAL DESCRIPTION Quarter Sections Section Township Range Lot Block Addition Tax Parcel # Short Plat Reference Total Number of Acres Property Description as shown on tax statement Individual Lot Sizes (square feet) Lot #1 Lot #2 Lot #3 Lot #4 City zoning classification Water Approval Wastewater Approval Official City Representative Official City Representative Road classification (as assigned by City Public Works Director prior to submittal of application)

3 CITY OF WHITE SALMON SHORT PLAT APPLICATION GUIDE Please complete all portions of the attached application. If you have any questions, contact the Public Works Department at The application will be reviewed by the City Public Works Director/Planner to be placed on the White Salmon Planning Commission agenda. The Planning Commission s decision is final unless an appeal is filed with the City Council within ten (10) days. The Planning Commission meets on the second and fourth Wednesday of each month at 5:30 PM. Applications must be complete and returned to the Planning Department at least three weeks before a scheduled meeting of the Planning Commission. This allows time for review before the agenda is set and to advertise the public hearing for a two week period in the local newspaper. It is a good idea to verify the required submittal date for the meeting at which you would like to have your application considered. Following is a list of the information to be submitted for a Short Plat Application: 1. Application Form - complete entirely with notarized signatures of all owners; 2. $750 plus $30 per lot plus twice the actual cost of postage per letter of notification for Single Family dwellings. $1,000 plus $30 per lot for Townhouses or Multi- Family dwellings. Radius Search - a list of the names and mailing address of all property owners within the 300-foot radius. A title company must verify this list; 3. $400 fee for Environmental Checklist (if applicable); 4. Certification by the owner (s) showing their contiguous ownership of land in which there is an interest by reason of ownership, contract for purchase, earnest money agreement or option by any person, firm or corporation in any manner connected with the development, and the names and addresses and telephone numbers of all such persons, firms or corporations; 5. The existing zoning classifications; 6. The square footage computation of each lot or parcel sufficiently accurate to show that each such lot or parcel contains at least sufficient footage to meet minimum zoning and health requirements; 7. The source of water supply, if any, and if a public system is used, the name of supplier;

4 8. The method of sewage disposal and if sanitary sewer is used, the name of the district having management over the system; 9. A current ownership certificate from a recognized title company; 10. Notarized signatures of owners to consent of the proposed Short Plat by individuals or parties holding any ownership interest in the land as identified in the Title Certificate. Two (2) 8 ½ x 11 and One large copy of the Plat Map prepared by a Washington Licensed Surveyor legibly drawn on good quality paper. The map shall be of such a scale to clearly show the following information: a. Boundaries of the total parcel included in the short plat and each individual lot being created; b. Legal description of the total parcel included in the short subdivision; c. Location of any roads, easements or rights-of-way proposed to serve the short subdivision; d. The date, scale and north arrow; e. The number assigned to each lot; f. The location and widths of any easements and rights-of-way for services and/or utilities within the area contained within the short subdivision; g. The boundaries of all lands reserved in the deeds for the common use of the property owners of the short subdivision; h. The approximate location of features lying within three (300) hundred feet of proposed short subdivision which will have an impact upon the short subdivision, such as all structures, existing or platted streets, watercourses, railroad right-of-way, all utility rights-of-way, township lines and section lines, etc. and; i. The approximate location of all drainage ways and watercourses including an arrow to indicate the direction of flow. SUPPORTING DOCUMENTS The following shall accompany each application for approval of a short plat: 1. A vicinity sketch of such a scale to clearly identify the location of the property being short subdivided; 2. Copies of restrictions, if any, presently encumbering the land or proposed to be imposed upon the use of the land. Such restrictions, if required by the county, shall be recorded with the final short plat;

5 3. In any short subdivision where lots are served or to be served by a private street, the subdivide shall furnish copies of such further covenants or documents that will result in each lot owner being fully notified of their responsibility as to any and all maintenance, reconstruction and/or improvements to all private streets serving the short subdivision and such covenants or documents shall obligate any seller to give actual notice to any prospective purchaser of the method of maintenance of the private street, which notice shall be included in any deeds or contracts relating to such sale and such covenants or documents shall be recorded simultaneously with the final short subdivision; 4. Plans and profiles of proposed roads and utilities as specified in Section 16.68; the City Public Works Director may waive this requirement; 5. Certification from the City Public Works Director that the water supply methods and sanitary disposal methods contemplated for use in the proposed short subdivision do or do not conform with current standards. A favorable report from the City Public Works Director shall not be construed as granting or guaranteeing water supply adequacy. If community sewer and/or water services are proposed, verification from the suppliers of the service (s) shall be submitted with the health officer s certification. Any short subdivision, which is adjacent to any other approved proposed subdivision of land, may require an environmental checklist. The application for a short subdivision shall not be considered as filed until such checklist has been completed and submitted to the Planning Department. If an environmental impact statement is required, then the application for short subdivision shall not be considered as filed until the final EIS has been completed and submitted to the Planning Department.

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