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Final Subdivision

Application

Planning Department

This permit application packet is designed to obtain all the information necessary to allow the City to make a well-

informed decision on your application. Please refer to the attached application checklist to determine the materials

that must be submitted to complete your application. All application materials are public information.

Your application will be evaluated on the basis of the information you provide, the criteria listed in the pertinent

sections of the Subdivision Ordinance, the Kirkland Comprehensive Plan, other City regulatory ordinances, inspection of

the property, as well as testimony and evidence presented through public comments.

YOU ARE ENCOURAGED TO MEET WITH A PLANNER FROM THE DEPARTMENT OF PLANNING AND COMMUNITY

DEVELOPMENT PRIOR TO AND DURING PREPARATION OF THE FINAL PLAT DOCUMENTS TO DISCUSS PROJECT

COMPLIANCE WITH CITY REGULATIONS AND TO OBTAIN GUIDANCE ON THE APPLICATION MATERIALS YOU MUST

SUBMIT.

Copies of City ordinances such as the Comprehensive Plan, Zoning Ordinance, Subdivision Ordinance, and Shoreline

Master Program are available at the Department of Community Development in City Hall, 123 Fifth Avenue; and the

Kirkland Public Library, 308 Kirkland Avenue. To purchase the Comprehensive Plan or Zoning Ordinance, call Code

Publishing Company at (206) 527 6851. The City ordinances can also be found on-line at www.kirklandwa.gov.

Primary Contact

Name

Address

City State Zip Code

Cell

Work

Note: If applicant is not property owner, he/she must be authorized as agent (see page 2).

Secondary Contact Person

Name

Address

City State Zip Code

Cell

Work

Prefer written correspondence by email provided Prefer written correspondence by address provided

Tax Parcel #

Name of Preliminary Subdivision

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If the proposed name of the Final Subdivision is different from the name of the Preliminary Subdivision, please

indicate proposed name

Department of Planning and Community Development File Number for Preliminary Subdivision

Does the proposed Final subdivision include all of the area included in the

Preliminary Subdivision?

Yes No

If not, provide a map which shows the area of the proposed Final Subdivision in relationship to the area of the

Preliminary Subdivision.

Describe any proposed deviations from the Preliminary Subdivision

Have you met with a planner prior to submitting your application?

Yes No

Name of Planner

STATEMENT OF OWNERSHIP/DESIGNATION OF AGENT

The undersigned property owners, under penalty of perjury, each state that we are all of the legal owners of the

property described in the attached legal description, and designate the person(s) listed below the to act as our agent

with respect to this application.

AUTHORITY TO ENTER PROPERTY

I/we acknowledge that by signing this application I/we are authorizing employees or agents of the City of Kirkland to

enter onto the property which is the subject of this application during the hours of 7:00 a.m. to 5:00 p.m., Monday

through Friday, for the sole purpose of making any inspection of the limited area of the property which is necessary to

process this application. In the event the City determines that such an inspection is necessary during a different time or

day, the applicant(s) further agrees that City employees or agents may enter the property during such other times and

days as necessary for such inspection upon 24 hours notice to applicant(s), which notice will be deemed received when

given either verbally or in writing.

HOLD HARMLESS AGREEMENT READ CAREFULLY BEFORE SIGNING

The undersigned in making this application certifies under penalty of perjury, the truth and/or accuracy of all

statements, designs, plans and/or specifications submitted with said application and hereby agrees to defend, pay, and

save harmless the City of Kirkland, its officers, employees, and agents from any and all claims, including costs, expenses

and attorney's fees incurred in investigation and defense of said claims whether real or imaginary which may be

hereafter made by any person including the undersigned, his successors, assigns, employees, and agents, and arising

out of reliance by the City of Kirkland, its officers, employees and agents upon any maps, designs, drawings, plans or

specifications, or any factual statements, including the reasonable inferences to be drawn therefrom contained in said

application or submitted along with said application.

I certify (or declare) under penalty of perjury under the laws of the State of Washington that the above answers are true

and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decisions.

Designated Agent:

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Applicant

Name

Address

City State Zip Code

Phone

Signature

Property Owner

Name

Address

City State Zip Code

Phone

Signature

Applicant 2

Name

Address

City

State

Zip Code

Phone

Signature

Property Owner 2

Name

Address

City State Zip Code

Phone

Signature

Land Area Worksheet

Project Name

Permit Number

Please provide the following area calculations (in square feet) for the entire plat

Total Land Area

R-O-W Dedication

Access Tract

Ingress/Egress

Stream/Wetland

Stream Wetland Buffer

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Lot Area Calculations

Please provide the following area calculations (in square feet) for each individual lot:

Parcel Size: