2020-01-BLA Page 4 of 4
BOUNDARY LINE ADJUSTMENT APPLICATION
SUBMITTAL CHECKLIST CONTINUED
12. Boundary Line Adjustment Map (Continued)
− Existing structures and distances to property lines
− Existing wells, septic systems (including tanks), drain fields, and reserve areas and distances to
property lines
− Parcels (identify as Lot A, Lot B, etc. and match to legal descriptions)
− Lot area and dimensions of all existing and proposed lots
− Existing and proposed legal descriptions for each lot, including area of conveyance
− Text designating the proposed lot line(s) and corresponding corrected legal description as the
legal property line(s)
− The location of all critical areas, per Chapter 21A.50 SMC
− In
clude signature blocks for city and county officials and property owners
13. Calculations, Lot Closures, Lot Summary
14. Storm Drainage Analysis (Technical Information Report) (if applicable)
15. PW Standards Deviation (if proposed)
16. Plan Set
CERTIFICATIONS & SIGNATURES
I have read this application in its entirety and certify that all information submitted, including any
supplemental information, is true and complete to the best of my knowledge. I acknowledge that willful
misrepresentation of information will terminate this permit application. I understand that my submittal will be
reviewed for completeness and, if found to be complete, will be processed pursuant to Chapter 20.05 SMC.
Applicant/Representative Signature (if applicable):
ONLINE SUBMITTAL INSTRUCTIONS
Create an account on MyBuildingPermit.com.
Select “Apply For Permit” and then select “Sammamish” as the jurisdiction.
Select the following:
Application Type
Land Use
Project Type
Any Project Type
Activity Type
Land Division
Scope of Work
Boundary Line Adjustment
C
omplete & save this form before uploading it in the “File Upload” section along with the required
submittal documents.
click to sign
signature
click to edit
click to sign
signature
click to edit