BINDING SITE PLAN Checklist

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Checklist This is a checklist of materials required for a Binding Site Plan. This checklist is provided to assist you in submitting a complete application. If you have any questions, contact the Planning and Development Services Department at (253) 566-5656. RETURN THIS CHECKLIST WITH YOUR APPLICATION Fees must be paid at the time of submittal. The table below indicates the standard number of sets required at the time of submittal. The number of plans is subject to change based on the scope of the project. # OF SETS REQUIRED 8 Binding Site Plan Application 8 Site Plan DESCRIPTION 8 Vicinity Map identifying proposed subdivision, including the nearest cross streets and a North arrow 8 SEPA Checklist 1 Title Report (must be dated within 30 days of application) 1 Notarized Owner Affidavit 4 Copy of Declarations of Covenants 2 Tree Survey (required if removing more than 5 trees): Location of all trees within the subdivision that are 6 caliper inches and above, measured 2 feet from the ground. Indicate all trees that are to be retained and those to be removed. 2 Landscape Plan 2 Water Availability Letter from Tacoma Water 1 Verification of Pierce County Assessor review submittal (copy of receipt) 1 Verification of Pierce County Utilities review submittal (copy of receipt and application) 1 Health Department Application Reviewed and Approved (must turn in 8½ x 14 application stamped as received by TPCHD along with receipt. Take 2 copies to the Health Department so you can take one away with you) 2 Property Listings, Map and Mailing Labels for all lots within 300 feet (but not less than two parcels deep) of subject property. (Obtained from Pierce County Assessor, title company, or other approved method) Page 1 of 1 Updated: 3/2013

Application Please type or print clearly. Incomplete information may delay the project approval. APPLICANT: Phone: Fax: PROPERTY OWNER: Phone: Fax: AGENT: Phone: Fax: PROJECT NAME & TYPE: Project Address: Parcel Number(s): Zoning: Current Use: Area/Acreage: Township: Range: Section: Quarter Section: Has this project been reviewed at a Technical Review Committee (TRC) Meeting? Yes No PROVIDE A DETAILED DESCRIPTION OF THE PROPOSAL. (MAY BE ATTACHED) Page 1 of 3 Updated: 3/2013

SERVICES: Source of Water: Source of Power: Sewage Disposal: Telephone: Natural Gas: Cable Television: SITE PLAN DETAILS: Total size of land to be subdivided: Number of commercial and industrial lots: Total area in open space and landscaping: Total number of lots to be created: Total number of tracts to be created: Total area in commercial and industrial buildings: Is there a master development plan for this development? Is the project proposed to be built in phases? If so, how many? List each building lot, size and proposed use of each: List each tract, size and proposed use of each: Number of building(s), size, location and proposed use of each: Proposed street system: Public Private Both Page 2 of 3 Updated: 3/2013

Total area in public streets: Total area in parking lots: Total area in private streets: Total area of other impervious surfaces: How many vehicle trips per day are to be generated by this development? (include formula for deriving this number): Will there be any shared common areas? (driveways, parking lots, landscaping): Are there any existing or proposed easements in the binding site plan area? Will there be any codes, covenants or restrictions on the lots created? Number of regular parking spaces: Number of compact parking spaces: Number and location(s) of loading areas: Number and location(s) of signs: I hereby certify under penalty of perjury under the laws of the State of Washington that I am the applicant listed above, and that all information and evidence herewith submitted are in all respects and to the best of my knowledge and belief, true and complete. I understand that the filing fee accompanying this application is not refundable, and is only for the purposes of defraying the normal administrative expenses of processing the application, and that the payment of said fees does not result in automatic issuance of the permit requested in this application. Print Owner Agent/Other (specify): Date: Page 3 of 3 Updated: 3/2013

Owner Affidavit DECLARATION: Know all men by these presents that we, the undersigned, owner(s) in fee simple and/or contract purchaser(s) of the land herein described do hereby make an application for a binding site plan thereof. The undersigned further declare that the attached map is the graphic representation of said binding site plan and the same is made with the free consent and in accordance with the desires of the owner(s). In witness whereof we have set with our hands and seals. ACKNOWLEDGMENT: STATE OF WASHINGTON ) ) ss COUNTY OF ) On this day appeared before me known as the individual(s) described in and who executed the within and foregoing (owner), to me instrument, and acknowledge that (he/she) signed the same as (his/her) free and voluntary act and deed, for the uses and purposes therein mentioned. GIVEN under my hand and official this day of,. Notary Public in and for the State of Washington Residing at My Commission Expires Page 1 of 1 Updated: 3/2013