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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 SHORELINE EXEMPTION APPLICATION (PLEASE PRINT CLEARLY OR TYPE IN BLUE OR BLACK INK) A determination of exemption is written approval from the Planning and Community Development Department Planning Director that confirms the proposed activity is exempt from a Shoreline Permit. The exemption can specify conditions that assure the activity complies with the provisions of the Shoreline Master Program (SMP). In all cases, the activity is required to implement best management practices to avoid degradation of the shoreline. Approval from the Planning Director is required prior to any work within the Shoreline Jurisdiction. NOTE: Other federal, state, and local regulations may apply. REVIEW PROCESS: The City will use a Type I or Type II process to review the application. A Type II process is required for projects that include a SEPA threshold decision. Type I is used for all other projects. BEFORE YOU APPLY: A Pre-Application Conference is required for Type II project applications, unless a written waiver is granted by the Planning Director. Pre-Application Conference form and Waiver Application are available at the Permit Center. APPLICATION REQUIREMENTS Additional information may be required by staff in order to evaluate a project for consistency with the SMP. A completed Land Use Application form Pre-Application Conference or waiver (Type II) SEPA Environmental checklist (Type II) Mailing list and labels (Type II) Application fee payment All of the materials and information required by this form SITE PLAN REQUIREMENTS On an 11 x17 scaled site plan identify the site boundary and all items below that apply to your exemption request. 4 scaled plans (min. 1 =20 ) with north arrow. 2 reduced 8 ½ x 11 site plans. Property lines including dimensions of the project site. Ordinary high water mark. Typical cross section or section showing: a. Existing ground elevations. b. Proposed ground elevation. c. Height of existing structures. d. Height of proposed structures. Where appropriate, proposed land contours using 5 foot intervals in water area and 10 foot intervals on areas landward of ordinary high water mark, if development involves grading, cutting, filling, or other alteration of land contours. PLN Shoreline Exemption 1

Show dimensions and locations of all existing structures, which will be maintained. Show dimensions and locations of proposed structures. Identify source, composition, and volume of fill material. Identify composition and volume of any extracted materials and identify proposed disposal area. Location of proposed utilities, such as sewer, septic tanks and drainfields, water, gas, electricity. If the development proposes septic tanks, does proposed development comply with local health and state regulations. Shoreline designation according to the Master Program. Show which areas are shorelines and which are shorelines of statewide significance. Lake Whatcom and Bellingham Bay seaward of extreme low tide are shorelines of statewide significance. VICINITY MAP: Indicate site location using natural points of reference (roads, state highways, prominent landmarks, etc.). If the development involves the removal of any soils by dredging or otherwise, identify the proposed disposal site on the map. If the disposal site is beyond the confines of the vicinity map, provide another vicinity map showing the precise location of the site and its distance to the nearest city or town. Give a brief narrative description of the general nature of the improvements and land use within one thousand feet in all directions from development site (i.e., residential to the north, commercial to the south, etc.). PROJECT DATA: 1. Name of adjacent water body: 2. Describe the current use of the property, including existing structures: 3. Describe the proposed project. Include the size of the property, the project dimensions and materials, and the total area of paving. 4. Nature of the existing shoreline. (Describe the type of shoreline-marine, stream, lake, lagoon, marsh, bog, swamp, flood plain, floodway, delta. Describe the type of beach- accretion, erosion, high bank, low bank, or dike; materials-sand, gravel, mud, clay, rock, riprap; and extent and type of bulkheading, if any): PLN Shoreline Exemption 2

5. In the event that any of the proposed buildings or structures will exceed a height of thirty-five feet above the existing grade level, indicate the approximate location of and number of residential units, existing and potential, that will have an obstructed view. ( AVERAGE GRADE LEVEL DETERMINATION: The natural or existing topography of the portion of the lot, parcel, or tract of real property, which will be directly under the proposed structure shall be used in calculating average grade level. Natural or existing topography shall mean the topography of the building site prior to any excavation, grading or filling. Calculation of average grade level shall be made by averaging the elevations at the center of all exterior walls of a building or structure): 6. Does SEPA apply? If so, provide a completed SEPA checklist concurrent with this application. PLN Shoreline Exemption 3

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 I PROCESS (Minor Administrative Decisions) Application 28 days max. Determination of complete or incomplete application. 120 days max. Decision 14 days max. Appeal 90 days max. Hearing Examiner open record appeal hearing Appeal decision 21 days max. Judicial appeal

TYPE II PROCESS (Administrative Decisions) 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