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Lewis County Community Development (Lewis County)

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The Lewis County Community Development (Lewis County) form is 5 pages long and contains:

  • 5 signatures
  • 9 check-boxes
  • 59 other fields

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File type: PDF

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Lewis County Community Development
2025 NE Kresky Ave, Chehalis, WA 98532 ● Phone: (360) 740-1146 ● Fax: (360) 740-1245
APPLICATION FOR AMENDMENT
Rezone or Amendment to Zoning Regulations Fee: $2,700
Comprehensive Plan Amendment
Resource Land Opt-in Application
Applications Accepted September 1 through December 31
SUBMITTAL REQUIREMENTS:
For office use only
Completed application form
Legal Description (for site specific amendments)
For map changes, site maps, no larger than 11” x 17”, clearly labeled, and reproducible in black
and white, that show the following features:
a. Property boundaries that show the existing land use designation and zoning.
b. Property boundaries that show the proposed land use designation and zoning.
c. All natural and built features (such as roads, streams, buildings, slopes, fences, etc.) as well as
adjacent properties and their uses.
PLEASE TYPE OR PRINT
1. Applicant (continue on page five if more than one applicant):
Name _____________________________________________________________________________
Address _____________________________________________________________________________
Contact Home (_____)_____________ Work (______) _______________ Email ___________________
2. Contact Person (if other than the applicant):
Name _____________________________________________________________________________
Address _____________________________________________________________________________
Contact Home (_____)_____________ Work (______) _______________ Email ___________________
Permit Tech
The State Environmental Policy Act (SEPA) Checklist and associated fees:
https://ecology.wa.gov/regulations-permits/sepa/environmental-review/sepa-guidance/sepa-checklist-guidance
For text changes, documentation that shows the proposed code or plan to be changed, as well as the proposed
language. Will only be processed with the consent of the Lewis County Board of County Commissioners.
Application Fee
S:\COMMUNITY DEVELOPMENT\Applications & Forms\Currently on Website
Updated November 2019
3. Assessor Tax Parcels:
4. Location of property:
Quarter Section __________, Section ______, Township ______ North, Range _______
Location (road name/city): _________________________________________________
Is the property within an Urban Growth Area? Yes ______ No ______
If yes, which jurisdiction? ___________________________________________________________
5. Total acreage of the parcel(s): _______________________________________________________
6. Signatures:
I/We the undersigned, do hereby affirm and certify, under penalty of perjury, that I am/We are
the owner(s) under contract of the described property, and that all statements contained in, or
attached to, this application are in all respects true and accurate to the best of our knowledge.
_____________________________________________________________________
Signature Date
_____________________________________________________________________
Signature Date
S:\COMMUNITY DEVELOPMENT\Applications & Forms\Currently on Website
Updated November 2019
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Lewis County Community Development
2025 NE Kresky Ave, Chehalis, WA 98532 ● Phone: (360) 740-1146 ● Fax: (360) 740-1245
APPLICATION FOR
AMENDMENT QUESTIONS
PLEASE AN
SWER THE FOLLOWING QUESTIONS. ATTACH ADDITIONAL SHEETS IF NECESSARY
A. Identify the land uses surrounding the property and how they will be affected by the proposed change:
B. Explain why the existing land use/zoning designation is not appropriate:
C. Explain how the conditions have changed so that the proposed designation is more appropriate than the
existing designation:
D. Explain why additional land of the proposed designation is needed in Lewis County, and why it is needed at
the location proposed:
Re
vision 11.14.2019
S:\COMMUNITY DEVELOPMENT\Applications & Forms\Currently on Website
Updated November 2019
E. If the property is in the rural area (outside of an Urban Growth Area), demonstrate with appropriate data,
how the rural density standards will be met:
F. Explain why the change is needed and the issues or problems resolved by the proposed change:
G. Explain how the proposed change serves the interests of not only the applicant, but the public as a whole:
H. Explain how the proposed rezone or amendment fulfills the goals of the Washington State Growth
Management Act (RCW 36.70A.020):
I. Explain how the proposed rezone or amendment is consistent with the policies of the Lewis County
Comprehensive Plan, including any policies of an applicable town or city (if the area is in the unincorporated
area of an Urban Growth Area). Be sure to review all comprehensive plan chapters:
Revision 11.14.2019
S:\COMMUNITY DEVELOPMENT\Applications & Forms\Currently on Website
Updated November 2019
ADDITIONAL APPLICANTS PAGE
Plea
se have every party who wishes to join this application provide the following information and sign below.
You may attach additional sheets if necessary.
I/We,
the undersigned, do hereby affirm and certify, under penalty of perjury, that I am/We are the owner(s)
under contract of the described property, and that all statements contained in, or attached to, this application
are in all respects true and accurate to the best of our knowledge.
Applicant:
Name ________________________________________________________________________________
Address ________________________________________________________________________________
Telephone Home (_____)__________________ Work (_____)__________________
E Mail _________________________________________________________________
Parcel Numbers _____________________________________________________________________________
Signature _________________________________________________________________________________
Applicant:
Name ________________________________________________________________________________
Address ________________________________________________________________________________
Telephone Home (_____)__________________ Work (_____)__________________
E Mail _________________________________________________________________
Parcel Numbers _____________________________________________________________________________
Signature _________________________________________________________________________________
Applicant:
Name ________________________________________________________________________________
Address ________________________________________________________________________________
Telephone Home (_____)__________________ Work (_____)__________________
E Mail _________________________________________________________________
Parcel Numbers _____________________________________________________________________________
Signature _________________________________________________________________________________
Revision 11.14.2019
S:\COMMUNITY DEVELOPMENT\Applications & Forms\Currently on Website
Updated November 2019
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Lewis County Community Development (Lewis County)

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Completed 21 January 2021

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