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Permit Center 210 Lottie Street, Bellingham, WA 98225 Phone: (360) 778-8300 Fax: (360) 778-8301 TTY: (360) 778-8382 Email: permits@cob.org Web: www.cob.org/permits Land Use Application Check all permits you are applying for in the boxes provided. Submit this application form, the applicable materials listed in the corresponding permit application packet(s) and application fee payment. Accessory Dwelling Unit Binding Site Plan Clearing Permit Conditional Use Permit Critical Area Permit Minor Critical Area Permit Design Review Grading Permit Home Occupation Institutional Interpretation Landmark Historic Certificate of Alteration Legal Lot Determination Nonconforming Use Certificate Project Information Project Tax Assessor Parcel Number (s) Project Description Parking Adjustment Application Planned Development Rezone SEPA Shoreline Permit Shoreline Exemption Subdivision-Short Plat/Lot Line Adjustment Subdivision-Preliminary Plat Subdivision-Final Plat Variance Wireless Communication Zoning Compliance Letter Other: Office Use Only Date Rcvd: Case #: Process Type: Neighborhood: Area Number: Zone: Pre-Ap. Meeting: Concurrency: Zip Code Applicant / Agent Name Mailing Primary Contact for Applicant City State Zip Code Phone Email Owner (s) Applicant Primary Contact for Applicant Name Mailing City State Zip Code Phone Email Property Owner(s) I am the owner of the property described above or am authorized by the owner to sign and submit this application. I grant permission for the City staff and agents to enter onto the subject property at any reasonable time to consider the merits of the application and post public notice. I certify under penalty of perjury of the laws of the State of Washington that the information on this application and all information submitted herewith is true, complete and correct. I also acknowledge that by signing this application I am the responsible party to receive all correspondence from the City regarding this project including, but not limited to, expiration notifications. If I, at any point during the review or inspection process, am no longer the Applicant for this project, it is my responsibility to update this information with the City in writing in a timely manner. Signature by Owner/Applicant/Agent, City and State where this application is signed:, City Date State

Permit Center 210 Lottie Street, Bellingham, WA 98225 Phone: (360) 778-8300 Fax: (360) 778-8301 TTY: (360) 778-8382 Email: permits@cob.org Web: www.cob.org/permits This application is for: Lot Line Adjustment Short Plat APPLICATION FOR SHORT SUBDIVISION (Process Type II, III-A or III-B) Pre-Application Steps: Pre-Application conference or waiver when critical areas permit is required Application Requirements: A completed Land Use Application form All of the materials and information required by this form Application fee payment Mailing list and labels for 500 foot radius Project Data: 1. Proposed Name of Short Plat / LLA 2. Nearest intersection 3. Licensed Land Surveyor Information (note: all subdivisions must be prepared by a licensed land surveyor.) Include firm name and address Process Type II short plats: Applications not using the 1- ½ Rule to round up the number of lots when density calculations result in at least.5 but less than.75 lot and consisting of: 1. 5-9 lots that are not using cluster subdivision provisions; 2. Short plats with up to 4 cluster lots that are not requesting a density bonus (Director may require Process Type III-A); and 3. Any Process Type I short plat application requiring a SEPA checklist. Process Type III-A short plats: 1. Applications using the 1- ½ Rule to round up the number of lots when density calculations result in at least.5 but less than.75 lot and not requiring a Type III-B process. Process Type III-B short plats: 1. Short plats of up to 4 cluster lots requesting a density bonus; and 2. Short plats of 5-9 cluster lots. PLN Short Subdivision II / III 4/25/2018 1

SHORT PLAT OR LOT LINE ADJUSTMENT SKETCH Show existing lot lines Show proposed lot lines Show adjacent streets and closest cross street Show existing structures and setbacks to proposed property lines Show lot dimensions of existing and proposed lots Please draw to 1 = 10 or 1 = 20 scale using black ink (pencil does not duplicate) For property described in a metes and bounds legal description, a deed dated prior to August 17, 1964 must be submitted containing the same legal description as the subject property. This also applies to legal descriptions containing a fraction of a platted lot. For your information and protection, please carefully read and keep this information sheet to familiarize yourself with short subdivision requirements and City review procedures prior to taking any steps to subdivide. Questions regarding short subdivisions should be directed to the Planning and Community Development Department at 778-8300 prior to submitting an application. 1. The APPLICANT shall complete the City of Bellingham Application for Short Subdivision. Please talk with a Planner before submitting an application. Process Type III-B short plats require a preapplication neighborhood meeting. See Neighborhood Meeting Instructions form. 2. All applications must be accompanied by a neat sketch drawing of the proposed division on a separate page no larger than 11 inches by 17 inches. The drawing should clearly show the existing and proposed lot lines and dimensions. Information on property lines may be obtained from the Kroll Atlas and/or the Whatcom County Assessor's Office located in the County Courthouse - 1st floor. 3. The application must also be accompanied by a mailing list and labels as described in the attached mailing list instructions. The mailing list includes owners of property located within 500 feet of the short plat boundary, neighborhood associations and Mayor s Neighborhood Advisory Commission representative(s). 4. A pre-application conference or waiver is required for applications that include a critical area permit. 5. After steps 1 through 4 are completed, formal application materials should be submitted to the Planning Department. An application review fee must be paid at this time. (Checks should be made payable to the Finance Director.) There is an additional filing fee, which must be paid prior to releasing the mylars for recording with the County Auditor. 6. All property contained within the proposed short subdivision must be served by City water and sanitary sewer or an approved septic system. All lots must have frontage on a publicly dedicated street and meet minimum zoning density and dimensional requirements. You will be contacted in writing when the review of the proposed division is completed and informed as to preliminary approval or denial, generally within thirty (30) days of your application date. 7. After preliminary approval of your application, a Washington State Licensed Land Surveyor must prepare the actual PLAT (Mylar) drawing. A Plat Certificate is required for all short subdivisions. This certificate can be ordered from a local title insurance company. Ordinarily, most of the communication regarding the plat drawings is made directly with the surveyor's office. Your surveyor will keep you informed of the progress of your application. If we can answer any questions during the process, feel free to contact the Planning Division at 360-778-8300. PLN Short Subdivision II / III 4/25/2018 2

MAILING LIST INSTRUCTIONS: As you get ready to prepare your labels keep the following checklist in mind: The information was acquired from the Assessor's office or database es for the following members have been included on the label sheet Property Owner Applicant / Contact for Proposal Bellingham Herald All property owners within the required 500' radius (100' for Home Occupation Applications) Applicable Mayor's Neighborhood Advisory Commission Representatives Applicable Neighborhood Association Representatives (This information can be found at http://www.cob.org/documents/planning/applications-forms/nbrhd-media-notification-list.pdf Mailing information has been printed on Avery 5160 labels (see attached example) All of the information completely fits on a single label Notarized Information Verification form has been completed NOTE: Errors in mailing labels may result in process delays and re-notice fees. Obtain Property Ownership Information from the Whatcom County Assessor s Office The Assessor s Office is located on the first floor of the Whatcom County Courthouse, 311 Grand Avenue, Bellingham, 360-676-6790. Bring enough information to identify all of the property in the project site, such as tax parcel numbers, legal descriptions, address(es) or boundary on a plat map. Assessor s Office staff can help you find the Assessor s map(s) containing the project parcel(s). Utilize the Assessor s map to measure the required ownership notice distance (listed on the application) and record the parcel number for each property within or partially within the required distance of 500 feet (100 feet for Home Occupation) from the boundary of the project parcel. If the owner of the project property owns other property within the notice distance but not included in the project site, contact the Planning Division to determine whether the notice radius must be increased. Record the property owner s name and mailing address by accessing each parcel number via the computer terminals at the Assessor s Office or through the Internet by accessing the database under Real Property Search at www.whatcomcounty.us/assessor/index.jsp. Click on the parcel number in the first data screen to bring up a screen with the owner s full address and zip code. The maps are also available at this site if you wish to check a parcel number. If the site is a condominium, include the owner of each unit. Print addresses on Avery 5160 labels Labels must include the address and fit on one Avery 5160 label: - Please DO NOT o Repeat names on the mailing list. If someone is listed as owning more than one property, only list the owner s name and address once on the mailing list. o List the tax parcel number on the labels Information Verification form: Form must be notarized and include a copy of the parcel numbers and property owner's name and mailing address information attached.

Information Verification I / We, being duly sworn on oath, hereby certify that I have familiarized myself with the rules and regulations with respect to preparing and filing this application, that the foregoing statements and the statements contained in any papers or plans submitted herewith are true to the best of my knowledge and belief, and that the list of names and addresses of property owners within 500 of the subject is complete and correct according to the records of the Whatcom Assessor's Office as of, 20. I understand that if this list does not contain accurate information as listed in the Assessor's Office, this application may be successfully challenged and result in the necessity to reapply. Signature: Date: Signature: Date: STATE OF WASHINGTON ) COUNTY OF WHATCOM ) ) SS SUBSCRIBED AND SWORN TO BEFORE ME THIS, 20. DAY OF Signature of Notary Public: Name Printed My appointment expires

Avery 5160 labels or in Avery 5160 label format Font Arial, 11 Property Owner Applicant MNAC Representative Neighborhood Association Rep Bellingham Herald Community News Department 1155 N. State St. Bellingham, WA 98225 All Property Owners within the specified radius: First name Last name First name Last name First name Last name

Parcel Number Site Property Owner Mailing

TYPE II PROCESS (Administrative Decisions) Optional or mandatory pre-application conference with staff Pre-application neighborhood meeting (for some permits) Application 28 days max. Determination of complete application; Notice of Application and Optional SEPA Notice (if used); Notice to determine if optional Board or Commission meeting required (some permits) 14-30 days min. If DS Prepare EIS or appeal DS to Hearing Examiner SEPA Decision (and notice with 14 day comment period, if applicable) Board or Commission meeting and recommendation (if required; also see meeting notice requirements) 120 days max. with exceptions Decision 10 days max. Notice of Decision 14 days max.; 21 days for Shoreline Permits Appeal - including any SEPA conditions or denial Hearing Examiner open record hearing (not available for Shoreline Permits that are instead appealed to State Shoreline Hearings Board) 90 days max. for Hearing Examiner Appeal decision 21 days max. Judicial appeal

TYPE III PROCESS (Hearing Examiner Decision) Optional or mandatory pre-application conference with staff Pre-application neighborhood meeting (for some permits) Application 120 days max. with exceptions 28 days maximum Determination of complete application, Notice of Application and Optional SEPA Notice (if used) SEPA Decision (and 14 day comment and/or appeal period, if applicable) 15 days min. 14-30 days min. IF DS, prepare EIS or appeal DS to Hearing Examiner by separate hearing Open Record Hearing, including any appeal of MDNS Hearing Examiner Decision, including any appeal of MDNS 10 days max. Notice of Decision 21 days max. 14 days max. Type III-A Judicial Appeal, including any SEPA appeal Type III-B Appeal to Council, including any condition or denial on the basis of SEPA 60 days max. Closed Record Appeal Hearing and Council Decision 21 days max. Judicial Appeal