Fillable Lot Line Alteration Application Planning Department Innovative - (City of Kirkland)

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Lot Line Alteration Application Planning Department Innovative - (City of Kirkland)

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Lot Line Alteration
Application
Planning Department
Page 1 of 2
DevSvcs-PMC-1.1-20150818
Innovative - Responsive - Professional
Complete this form to submit at City Hall. Or, use mybuildingpermit.com to submit your application entirely online.
The following is a list of materials that must be submitted with your application. Consult with the Department of
Planning & Community Development if you have a question. You are encouraged to meet with a planner in advance of
submitting your application to discuss your proposal and obtain guidance on the application materials. Your application
will not be accepted until all items which apply to your proposal have been checked off.
OWNER PROPERTY #1
Name:
Address:
City: State: Zip Code:
Daytime #:
Alternate #
Email:
Subject Property address, if different from above:
Parcel #
Property Zone:
Current Use of Property:
Have there been any previous zoning permits for the subject property?
Yes No
Are there any pending building permits for the subject property?
Yes No
OWNER PROPERTY #2
Name:
Address:
City: State Zip Code
Daytime #
Alternate #
Email:
Subject Property address if different from above:
Parcel #
Property Zone: Current Use of Property:
Have there been any previous zoning permits for the subject property?:
Yes No
Are there any pending building permits for the subject property?:
Yes No
Page 2 of 2
DevSvcs-PMC-1.1-20150818
Lot Line Alteration Application - continued
LICENSE TO ENTER PROPERTY
OWNER PROPERTY #1
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 AM to 5:00 PM, 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.
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further
certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts
required to enable the jurisdiction to process and review such application. I have furnished true and correct
information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of
work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Signature of Property Owner #1:
Signature of Property Owner #2:
Alternate Formats: Persons with disabilities may request materials in alternative formats. Persons with hearing
impairments may access the Washington State Telecommunications Relay Service at 711.
Title VI: Kirkland's policy is to fully comply with Title VI of the Civil Rights Act by prohibiting discrimination against any
person on the basis of race, color, national origin or sex in the provision of benefits and services resulting from its
programs and activities. Any person who believes his/her Title VI protection has been violated, may file a complaint
with the City.
To request an alternate format, file a complaint or for questions about Kirkland's Title VI Program, contact the Title VI
Coordinator at 425-587-3011 or titlevicoordinator@kirklandwa.gov.
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Lot Line Alteration Application Planning Department Innovative - (City of Kirkland)

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Completed 3 August 2020

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