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LAND USE PERMIT APPLICATION Date Application No. TYPE OF PERMIT Subdivision Short Plat Conditional Use Binding Site Plan Final Plat Final Short Plat Variance Final Binding Site Plan Plat Amendment Short Plat Amend. PUD Rezone 1. APPLICANT MAILING ADDRESS DAY PHONE NO. FAX NO. Section 2 - For Home Occupation Conditional Use applications only No. of non-family members employed. Will customers come to the home? Yes No Percentage of living space used for Home Occupation % Will there be any signs? Yes No Will stock be stored on the premises? Yes No Will mechanical equipment be used? Yes No Section 3 Property Owner Information 3. RELATIONSHIP OF APPLICANT TO PROPERTY Owner Purchaser Lessee Other NAME, ADDRESS AND PHONE NO. OF PROPERTY OWNER(S), IF OTHER THAN APPLICANT: 4. LOCATION (STREET ADDRESS), WHERE PROPOSED ACTIVITY EXISTS OR WILL OCCUR TAX PARCEL # (s) LEGAL DESCRIPTION (ATTACHED IF NECESSARY)

TOTAL SITE SIZE (square ft) PROPOSED # LOTS ZONING DISTRICT (Circle One) SF MF SR AR C/I DB W P COMPREHENSIVE PLAN DESIGNATION SHORELINE DESIGNATION 5. SURVEYOR WA REGISTRATION # PHONE FAX 6. ENGINEER WA REGISTRATION # PHONE FAX Section B - Please Write In the Sources of the Following Utilities/Facilities Source of Potable Water Method of Sewage Disposal Natural Gas purveyor Electric Service Telephone purveyor Cable/TV Service Section C - Project Description (Continue on separate paper if needed) Page 2 of 7

I (We) acknowledge that: Section D - Please Read and Sign the Following Acknowledgement 1. The information, plans, maps and other materials submitted on and with this application are to the best of my/our knowledge, a true and accurate representation of this proposal; 2. This application shall be subject to all additions to and changes in the laws, regulations and ordinances applicable to the proposed development until a determination of completeness has been made pursuant to KMC 14.07.050; 3. The City of Kittitas does not guarantee success of this permit application and/or the issuance of an affirmative notice of action. The City's assistance to the applicant(s)/owner(s) does not preclude the need to address impacts raised by the public or by other federal, state or local agencies: 4. In t he event of any legal proceeding to challenge this application, any environmental determination or any other aspect of the proposed development, the Applicant(s)/Owner(s) shall be solely responsible to defend such challenge and pay all court costs and attorney's fee s necessary for such defense: 5. If the Applicant is not the owner of the real property which is the subject of the permit application, this application and acknowledgment shall also be executed by each owner; 6. Only that person identified in Section A as the "Authorized Agent" will receive correspondence and notices regarding this application. 7. All persons executing this acknowledgment in a representative capacity shall be personally liable and hereby personally guarantee payment of all fees, expenses and costs required by this application. 8. If the applicant(s), representative(s) and/or owner(s) fail to respond to a request by the City to submit additional information, or the applicant(s), representative(s) and/or owner(s ) request, orally or in writing, that further processing be suspended or postponed, and if such failure to respond or requested suspension/postponement exceeds six months, the application shall be considered abandoned and all proposed development, uses and activities shall only be further considered in the submission of a new application and fees: and 9. This application does not constitute approval of the proposed development activity and it is acknowledged that additional permit applications and approvals may be necessary to conduct specific activities. Dated: Applicant: Applicant: Dated: Owner: Owner: Page 3 of 7

Section E - SITE PLAN CHECKLIST (Subdivisions see Sections F & G) Must be drawn to a standard engineering scale. Indicate the scale used. Must include North arrow. Boundaries (all property lines), dimensions, and area of lot/parcel (square feet or acreage). Land features such as top and bottom of slopes, direction of slope, ravines, location of wetlands, streams, lakes, rivers, ordinary high water mark of shoreline areas, fish and wildlife habitat. Location, size, and purpose of all existing structures (temporary or permanent) and proposed structures. Label each as existing or proposed. Existing and proposed landscaping, screening and/or fencing. (Show type of landscaping, size, spacing, and provisions for irrigation). Locations, dimensions and volume of all existing and proposed propane tanks, fuel tanks, etc. Location and dimensions of all decks, roof overhangs, porches, cantilevers, bay windows, retaining walls, patios, and chimneys. Distance between property lines and existing/proposed buildings and distances between buildings. Location and width of existing and proposed driveways/accesses serving each structure and any parking area. Include drainage facilities such as drains, detention ponds, catch basins etc. Name of roads bordering the property and indicate whether they are public or private. Indicate any and all easements (access, utility, drainage, etc.) on the property including their width. I hereby certify that the information on this site plan is accurate and complete. I further understand if the information is incomplete, incorrect, or not provided the application will not be accepted as a complete application. Applicant Name: Applicant Signature: Date: Page 4 of 7

Section F - Preliminary Land Division Ten copies of the preliminary plat which shall be a legibly drawn map, 18 by 24 inches in size for short subdivisions; 24 by 36 inches in size for subdivisions and binding site plans at a scale of one inch equals 50 feet or one inch equals 100 feet. If approved by the department, an alternative appropriate scale may be used; Every preliminary plat shall contain the following information: 1. Name, address and telephone number of the owner of the subject property and the person with whom official con tact should be made regarding the short subdivision, subdivision, or binding site plan; 2. Title of the proposal; 3. Location of subject property by section, township and range; 4. A written narrative describing the proposal including, but not limited to, the number of proposed lots, nature of surrounding properties, proposed access and timing of phasing of the development. The narrative shall also address compliance to applicable sections of the development code and other applicable regulations: 5. Vicinity map that clearly indicates the subject property: 6. North arrow, scale and boundary of the proposed short plat, plat, or binding site plan: 7. Boundaries of all blocks, the designation of lots, lot lines and dimensions; 8. Location of existing utilities; 9. Location, names and widths of all existing and proposed streets. roads and access easements within the proposed short subdivision, subdivision, or binding site plan and within 100 feet thereof, or the nearest City street if there is no City street within 100 feet of the subject property; 10. All existing or proposed easements or tracts proposed to be dedicated for any public purpose or for the common use of the property owners of the land division with description of the purpose of the common area; 11. Location of any natural features such as wooded areas, streams, drainage ways, or critical areas as defined in KMC Title 18; 12. Location of existing buildings, septic tanks, drain fields, wells or other improvements, indicating if they will remain or be removed; 13. A statement as to whether any adjacent property is platted or unplatted. If platted, give the name of the land division. If the proposed land division includes the division of a portion of an existing plat, the approximate lines of the existing plat are to be shown and a copy of the existing plat, along with any and all recorded covenants and easements; 14. Topographic information at two-foot intervals, identification of the existing drainage pattern and any creeks or other drainage facilities. Topographic information required by this section must be collected by or under the direct ion of a professional land surveyor; 15. Site data table" showing number of proposed lots, frontage for each lot, lot area for each lot, existing zoning, water supplier, method of wastewater disposal, and additional information as required by the city. One reduced (8 1/2" x I I " or I I " x 17") copy o f the preliminary plat; One copy of the County assessor's map clearly indicating the subject property. Additionally, all adjacent properties with parcel numbers must be indicated on the map. Assessor's maps for preliminary subdivisions shall indicate the parcel numbers of all properties within 400 feet of the subject property, unless the applicant owns adjacent property, in which case the map shall show the location and parcel number of all properties within 400 feet of the applicant's ownership; Street layout map with center lines of adjacent streets; An accurate and complete legal description of the subject property with t he source of the legal description clearly indicated with area in acres together with a plat certificate or subdivision guarantee dated within 45 days of the submittal. Copies of all deeds and easements referred to in the plat certificate shall be furnished with the submittal; SEPA environmental checklist for preliminary subdivisions and binding site plans; and Materials required with in Title 14 Page 5 of 7

Section G - Final Land Division The final land division shall incorporate all conditions of the preliminary approval, including those imposed by the Hearing Examiner. All final land division submittals shall include the following: 1. A minimum of 10 copies of the proposed final short plat, plat or binding site plan; 2. Appropriate fees; 3. Three copies of a plat certificate issued within 60-days of submittal; and 4. Maps and exhibits shall also be submitted in one of the following electronic file formats: a. AutoCAD.dwg (National CAD Standard); b. ESRI.shp (fully thematically classified layers); c. Microstation.dgn (National CAD Standard); or d. Other format approved by the Administrator. The final plat shall show: 1. All monuments found, set, reset, replaced or removed, describing their kind, size and location and giving other data relating thereto; 2. Bearing trees, corner accessories or witness monuments, basis of bearings, bearing and length of lines, scale of map and north arrow; 3. Any other data necessary for the interpretation of the various items and 1ocations of the points, lines and areas shown; 4. Ties to adjoining surveys of record; 5. The allowable error of mathematical closure for the final plat map shall not exceed one foot in 80,000 feet or 0.04 foot, whichever is greater; 6. Bearings and lengths are to be shown for all lines; no ditto marks are to be used; 7. Arrows shall be used to show limits of bearings and distances whenever any chance of misinterpretation could exist; 8. Plat boundary and street monument lines having curves shall show radius, arc, central angle and tangent for each curve and radial bearings where curve is intersected by a non-tangent line. Spiral curves shall show chord bearing and length; 9. Lots along curves shall show arc length along curve and radial bearings at lot corners. If a curve table is provided, it shall show angle for each segment of the curve along each lot, arc length, tangent length, and radius. Radial bearings along lot lines will not be required; 10. All dimensions shall be shown in feet and hundredths of a foot. All bearings and angles shall be shown in degrees, minutes and seconds; 11. When elevations are needed, permanent bench mark(s) shall be shown on the final plat in a location and on a datum plane approved by the City; 12. The final plat shall indicate the actual net area for each platted lot exclusive of the right-of-way. Lots one acre and over shall be shown to the closest hundredth of an acre, and all other lots shall be shown in square feet; and 13. The final land division shall show or be accompanied by a map showing the control system through which the coordinates were determined from points of known coordinates in conformance with RCW 58.09.070. All surveys shall comply with the Survey Recording Act (Chapter 58.09 RCW), survey and land descriptions (Chapter 332-130 WAC), and City standards for road construction. The contents of a final land division shall include the following : 1. The final plat shall be a legibly drawn, printed, or reproduced permanent map. Final short plats shall measure 18 by 24 inches. Final plats and binding site plans shall measure 24 by 36 inches. A two-inch margin shall be provided on the left edge, and a one-half-inch margin shall be provided at the other edges of the plat. If more than one sheet is required, each sheet shall show sheet numbers for the total sheets. 2. The file number of the land division, location by section, township and range shall be shown. 3. The scale shall be 50 (one inch equals 50 feet) or 100 (one inch equals 100 feet) feet to the inch. If approved by the Administrator, an appropriate scale may be used which does not exceed 200 (one inch equals 200 feet) feet to the inch, provided a 400 (one inch equals 400 feet) feet to the inch reduced copy is also submitted. 4. A distinct wide boundary line shall delineate the boundary of the land division. Page 6 of 7

5. The location and widths of existing and proposed streets, alleys, rights-of-way, easements, parks and open spaces within the land division, including those existing immediately adjacent to the land division shall be shown. Areas to be dedicated to the public must be labeled. 6. Layout and names of adjoining land divisions shall be shown within and adjacent to the land division boundary. 7. The layout, lot and block numbers, and dimensions of all lots shall be shown. 8. Street names shall be shown. 9. Street addresses for each lot shall be shown. 10. Plat restrictions required as conditions of preliminary approval shall be shown. 11. Appropriate utility easements shall be shown. 12. Any special statements of approval required from governmental agencies, including those pertaining to flood hazard areas, shorelines, critical areas, and connections to adjacent state highways shall be shown. 13. A notarized certification by the owner(s) as shown on a current plat certificate shall be provided dedicating streets, areas intended for other public use, and granting of easements for slope and utilities. 14. A certification signed by a professional land surveyor registered in the state of Washington stating that the final land division and final plat was surveyed and prepared by them, or under their supervision; that the plat is a true and correct representation of the subject land; and that monumentation has been established as required by City standards. Final approval of any final plat is authorized upon re view. approval and signature by the following: 1. City Engineer; 2. Administrator; 3. Utilities director, as necessary; 4. County Treasurer; 5. County Assessor; 6. County Auditor (recording number) ; 7. Fire Department Representative; and 8. Signatures of all person/entities identified on the plat certificate as having a fiduciary, fee or ownership interest in the property, which includes beneficiaries of financial interest, judgments and liens. Materials required with in Title 14 Page 7 of 7