Conditional Use Permit Application Page 1 of 3 (Revised 9/24/2014)
City of DuPont
Planning Division
Conditional Use Permit Application
Phone: (253) 912-5393
Fax: (253) 964-1455
1700 Civic Drive
DuPont, WA 98327
www.dupontwa.gov
City File Number: _____________________________
All information listed in this application, or by applicable ordinance, must be submitted in order for a
Conditional Use Permit land use application to be determined complete. Only a complete application will
be processed for conformance with adopted policies and requirements.
General Information:
Project name: __________________________________________________________
Applicant name: ________________________________________________________
Address: ______________________________________________________________
Phone number: ________________________________ Fax number: _______________
Applicant’s representative:
Address:
Phone number: ________________________________ Fax number: ____________
Description of proposal. Be specific.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Site Information:
Area of site in square feet:
Area of streets and alleys:
Area of storm drainage improvements and conveyance lines:
Area of open space and neighborhood green tracts:
Area of critical areas and buffers:
Area of building floors:
Conditional Use Permit Application Page 2 of 3 (Revised 9/24/2014)
Area of impervious surfaces:
Area of landscaping:
Building height:
Number of dwelling units:
Number of employees:
Number of disabled, compact and standard parking stalls:
Description and area of all proposed tracts:
Required Plans, Information and Fee:
(Quantity and minimum scale of each item or drawing is indicated in parenthesis. Plans shall be no larger than 24 by
36 inch sheet size)
1. Vicinity Map (include as part of site plan).
2. Site Plan drawn at 1”=20’. (seven copies)
3. Landscape Plans identifying: location, size and species of all landmark, historic and specimen trees; trees
to be retained, specific tree protection measures drawn at 1”=20’. (seven copies)
4. Grading Plan with estimated dimensions and quantities of work involved drawn at 1”=20’ horizontal with 2’
contour intervals. (seven copies)
5. Storm Drainage and Utility Plan drawn at 1”=20’. (seven copies)
6. Preliminary Stormwater Management Report and calculations. (three copies)
7. Roadway cross sections, (single line dimension). (seven copies)
8. One each 8 by 11 inch reduction of all drawings.
9. Average daily trips generated by the proposal based on the International Transportation Engineers Trip
Generation Manual. (two copies)
10. Building Elevations drawn at ¼”=1’ or larger. Identify building materials and colors (seven copies)
11. Title report of subject lot that is less than 30 days old to identify all encumbrances. (two copies)
12. Draft of proposed covenants, conditions and restrictions related to the maintenance of open space or
commonly owned improvements, if applicable. (two copies)
13. Letter of Sewer Availability from Pierce County. (two copies)
14. Letter of Water Availability from City of DuPont. (two copies)
15. Letter of Refuse Enclosure Approval from LeMay Inc. (one copy) Contact person is Dick Rehn, Service
Coordinator, 253-537-8687
16. Completed environmental checklist. (two copies)
Conditional Use Permit Application Page 3 of 3 (Revised 9/24/2014)
17. Prestamped envelopes addressed to all property owners within 300 feet of the subject site and list of
addresses. (one set)
18. Completed Conditional Use Permit Application. (one copy)
19. Written answers to each of the five decisional criteria of DuPont Municipal Code 25.135.030. (one copy
paper and one copy in Word format)
20. Completed Agent Affidavit.
21. Filing fee(s).
Note:
Fill out and return this application with all material listed in the Required Plans, Information and Fee
section. All plans must be folded to by 11 inch size. You will be contacted by the City within 28 days
of formal application submittal regarding whether the application is complete. Site work may not start
until all necessary permits have been obtained. Paper or electronic drawings of the proposal may be
requested for presentation purposes.
(Applicant Signature) (Date) (Print name)
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signature
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