Comprehensive Plan Amendment Application Page 1 of 1 (Revised 9/24/2014)
City of DuPont
Planning Division
Comp Plan Amendment Application
Phone: (253) 912-5393
Fax: (253) 964-1455
1700 Civic Drive
DuPont, WA 98327
www.dupontwa.gov
City File Number:_______________________
General Information:
Your name: __________________________________________________________________________
Address: ____________________________________________________________________________
Phone number:(____)___________________________Fax number:(____)________________________
Your client’s name: ____________________________________________________________________
Address: ____________________________________________________________________________
Phone number:(____)___________________________Fax number:(____)________________________
Comprehensive Plan Amendment Application Submittal Requirements:
If the amendment concerns specific real property:
□ Both a general and legal description of the property;
□ Description of the plan amendment being requested;
□ Statements addressing the purpose of the amendment and why the amendment is being requested,
including addressing the decisional criteria of Section 25.170.090 of the DuPont Municipal Code;
□ Completed environmental checklist and filing fee;
□ List of the names of owners of all property of record within 300 feet of the subject property and two sets of
stamped envelopes addressed to the same;
□ Completed Agent Affidavit.
□ Payment of all applicable filing fees. In the event of insufficient funds on draft, the application shall be
deemed null and void.
Statement:
I have read the applicable sections of the DuPont Municipal Code regarding comprehensive plan
amendments. The foregoing application is, to the best of my knowledge, accurate and in compliance with
applicable city regulations. I understand that failure to follow applicable city regulations may result in
prosecution by the City.
_________________________________________ ____________________________________
(Signature) (Date) (Print name)
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signature
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