substandard lot of record certification form...jan 05, 2005 · f:\shared\forms 2005...

F:\shared\Forms 2005 Continental\Current Planning\Application for Review of Substandard lot.pds.doc – last updated 01.05.05 1

Skagit County Planning & Development Services 1800 Continental Place - Mount Vernon, WA 98273

Inspections (360) 336-9306 - Office (360) 336-9410 - Fax (360) 336-9416

PL#: Date Received

Substandard Lot of Record Certification Form

Review for development on a lot of record that does not meet the minimal dimensionalrequirements of Skagit County Code pursuant to 14.16.900.850(4).

1. Applicant Name

2. Parcel ID#: Assessor Tax #: - - -

3. Adjoining parcels under same ownership:

Parcel ID#: Assessor Tax #: - - -

Parcel ID#: Assessor Tax #: - - -

4. Section Township Range Comprehensive Plan/Zoning Designation:

5. Lot Size and Dimensions:

6. Site Address:

7. Legal Description:

(Attach additional sheet if necessary.)

8. Please attached a full sized 18”X24” Section Map purchased from the Assessor's office.

9. Please answer the following questions and provide supporting documentation asrequested. After the first yes, there is no need to answer further questions.

a. Has the lot been previously certified as a legal lot of record? YES NOIf the answer is yes, please attach a copy of the lot certification or list the file

number

b. Is there or has there been a legally placed residence on the lot? YES NOIf the answer is yes, please provide one of the following:

Related permit numberAssessor’s documentation attached YES NOOther documentation attached YES NO


c. Is this a lot of record on which a previous development permit has been issuedpursuant to Skagit County Code? YES NO

If yes, please note the number of the related permit number(s)

d. If none of the above is yes, please submit the following items for further review:

• Submit an application for an on-site soil evaluation: Pl# .The lot of record must be compliant with all other requirements for a development permitpursuant to SCC 14.16.850(4)(d)(i).

• This project will be routed for concurrency review. A Certificate of Capacity is required for issuance of a development permit.

Or submit evidence that a development permit is required as part of a compliance order toprotect the public's health, life, safety, and the environment


1. Applicant

Name

Address

Phone Fax e-mail address

2. Owner

Name

Address

Phone e-mail addressFax

3. Contact

Name

Address

Phone Fax e-mail address


Return Name & Address

Planning & Development Services1800 Continental Place – Mount Vernon, WA 98273 – (360) 336-9410

Applicant Name: Phone:

Lot Certification File Number: PL -

Grantee/Property Owner’s Name:

Having reviewed the information provided by the applicant, I hereby find that the parcel(s)bearing Assessor’s Account Number(s):

P#

P# P# P#

Notwithstanding other restrictions of Skagit County Code, the lot of recordMEETS the requirements of SCC 14.16.850(4) and is suitable for buildingpurposes.Notwithstanding other restrictions of Skagit County Code, the lot of recordDOES NOT meet the requirements of SCC 14.16.850(4) and is not suitable forbuilding purposes.

Grantor/Skagit County Planning & Development Services

Date: Authorized Signature:Title:

SUBSTANDARD LOT OF RECORD CERTIFICATION

DATE STAMP

F:\shared\Forms 2005 Continental\Current Planning\Application for Review of Substandard lot.pds.doc – last updated 01.05.05




Skagit County Planning & Development Services

1800 Continental Place - Mount Vernon, WA 98273

Inspections (360) 336-9306 - Office (360) 336-9410 - Fax (360) 336-9416

PL#:

Date Received

Substandard Lot of Record Certification Form

Review for development on a lot of record that does not meet the minimal dimensional requirements of Skagit County Code pursuant to 14.16.900.850(4).

1. Applicant Name

2. Parcel ID#:

Assessor Tax #:

-

-

-

3. Adjoining parcels under same ownership:

Parcel ID#:

Assessor Tax #:

-

-

-

Parcel ID#:

Assessor Tax #:

-

-

-

4. Section

Township

Range

Comprehensive Plan/Zoning Designation:

5. Lot Size and Dimensions:

6. Site Address:

7. Legal Description:

(Attach additional sheet if necessary.)

8. Please attached a full sized 18”X24” Section Map purchased from the Assessor's office.

9. Please answer the following questions and provide supporting documentation as requested. After the first yes, there is no need to answer further questions.

a. Has the lot been previously certified as a legal lot of record?

YES

NO

If the answer is yes, please attach a copy of the lot certification or list the file

number

b. Is there or has there been a legally placed residence on the lot?

YES

NO

If the answer is yes, please provide one of the following:

Related permit number

Assessor’s documentation attached

YES NO

Other documentation attached

YES NO

c. Is this a lot of record on which a previous development permit has been issued

pursuant to Skagit County Code?

YES NO

If yes, please note the number of the related permit number(s)

d. If none of the above is yes, please submit the following items for further review:

· Submit an application for an on-site soil evaluation: Pl#

.

The lot of record must be compliant with all other requirements for a development permit pursuant to SCC 14.16.850(4)(d)(i).

· This project will be routed for concurrency review. A Certificate of Capacity is required for

issuance of a development permit.

Or submit evidence that a development permit is required as part of a compliance order to

protect the public's health, life, safety, and the environment

1. Applicant

Name

Address

Phone

Fax

e-mail address

2. Owner

Name

Address

Phone

e-mail address

Fax

3. Contact

Name

Address

Phone

Fax

e-mail address

Return Name & Address

Planning & Development Services

1800 Continental Place – Mount Vernon, WA 98273 – (360) 336-9410

Applicant Name:

Phone:

Lot Certification File Number: PL

-

Grantee/Property Owner’s Name:

Having reviewed the information provided by the applicant, I hereby find that the parcel(s) bearing Assessor’s Account Number(s):

P#

P#

P#

P#

Notwithstanding other restrictions of Skagit County Code, the lot of record

MEETS the requirements of SCC 14.16.850(4) and is suitable for building purposes.

Notwithstanding other restrictions of Skagit County Code, the lot of record

DOES NOT meet the requirements of SCC 14.16.850(4) and is not suitable for building purposes.

Grantor/Skagit County Planning & Development Services

Date:

Authorized Signature:

Title:

SUBSTANDARD LOT OF RECORD CERTIFICATION

DATE STAMP

Planning & Permit Center

lindak

Normal

robint

8

Microsoft Office Word

1/5/2005 3:10:00 PM

5/26/2004 11:05:00 AM

1/5/2005 3:23:00 PM

27

4

531

4596

4

Skagit County

94208

184

73

5229

: CheckBox5: 0CheckBox7: 0CheckBox1: 0CheckBox2: 0CheckBox3: 0CheckBox4: 0CheckBox6: 0CheckBox8: 0CheckBox9: 0CheckBox10: 0

substandard lot of record certification form...jan 05, 2005 · f:\shared\forms 2005...

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