173-27-310  <<  173-27-990 >>   End of Chapter

WAC 173-27-990

Appendix A.

Appendix A
Shoreline Management Act
Permit Data Sheet and Transmittal Letter
From:
(local government)
 
To:
(appropriate Ecology office)
 
 
 
 
 
 
 
 
 
Date of Transmittal:
 
 
Date of Receipt:
(provided by Ecology)
Type of Permit: (Indicate all that apply)
 
Substantial Development ; Conditional Use ; Variance ; Revision ; Other .
Local Government Decision: Approval ; Conditional Approval ; Denial :
Applicant Information:
Applicant's Representative: (if primary contact)
Name:
 
 
Name:
 
 
 
 
Address:
 
 
Address:
 
 
 
 
 
 
 
 
 
 
Phone(s):
 
 
Phone(s):
 
 
 
 
Is the applicant the property owner? yes no
Location of the Property: (Section Township and Range to the nearest 1/4, 1/4 Section or latitude and longitude, and a street address where available)
 
 
 
Water Body Name:
 
Shoreline of Statewide Significance: Yes No .
Environment Designation:
 
Description of the Project: (Summary of the intended use or project purpose)
 
 
 
Notice of Application Date:
 
Final Decision Date:
 
By:
(Local Government Primary Contact on this Application)
Phone No:
 
 
[Statutory Authority: RCW 90.58.140(3) and [90.58].200. WSR 96-20-075 (Order 95-17), § 173-27-990, filed 9/30/96, effective 10/31/96.]
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