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Land Use Permit Application

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Steps

1. General Information This section is complete This section is incomplete
2. Owner Information This section is complete This section is incomplete
3. Project Details This section is complete This section is incomplete
4. Land Use Permit Components This section is complete This section is incomplete

General Information

Site Address
Address 2
City
State
Zip
Date of Application
Date of Application
Application Number
Receipt Number
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Owner Information

Owner Name
Or name of business
Owner Phone Number
Mailing Address
City
State
Zip
Owner's Authorized Agent Name
Owner's Authorized Agent Phone Number
Owner's Authorized Agent Address
City
State
Zip
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Project Details

Contact Person
Phone Number
Description of Project
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Land Use Permit Components

Applied For
1. Binding Site Plan
2. Comprehensive Plan Amendment
3. Conditional Use Permit
4. Environmental Review
5. Establish or Change Use
6. Flood Plain Variance and Appeals
7. Full Subdivision (Primary Lot)
8. Lot Boundary Adjustment
9. Noise Standards Variance
10. Plan Review
11. Shoreline Substantial Development Permit
12. Short Subdivision
13. Temporary Uses for More Than Two Weeks
14. Temporary Uses for Up to Two Weeks
15. Zoning Map Amendment (Rezone and Contract Rezones)
16. Zoning Variance - Including Signs
By affixing my signature, I hereby certify that I am the owner of the property for which this permit is issued or am an authorized representative of the owner.

All provisions of laws and ordinances governing this type of work will be complied with including obtaining all required building, street use and related permits.
Signature of Owner or Authorized Agent
Date
Date

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Burlington, WA 98233
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