Months: Days: Hours: 11. What is the surface type of the county/state road in which the facility accesses? Paved Gravel Dirt

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1 Please Answer the Fllwing Questins: (attach sheet if needed) 1. What type f facility is being prpsed? CAMPGROUND & RV PARK FORM Yakima Cunty Public Services 128 Nrth Secnd Street Furth Flr Curthuse Yakima, Washingtn (509) FAX (509) FINAL Revised 10/1/15 Campgrund Recreatinal Vehicle (RV) Park Bth 2. What is the ttal acreage f the prpsed facility? 3. What is the ttal number f prpsed campgrund and/r RV spaces? 4. What are the existing structures n-site? 5. What structures are prpsed? 6. What are the prpsed mnths, days and hurs f peratin? Mnths: Days: Hurs: 7. List the mnths f peratin fr the facility: 8. What are yur prpsed methds f strmwater treatment? 9. Are fencing, landscaping and site screening indicated n site plan? Yes N 10. Are adjacent residences indicated n the site plan? Yes N 11. What is the surface type f the cunty/state rad in which the facility accesses? Paved Gravel Dirt 12. What is the surface type f any prpsed/existing private r interir radway? Paved Gravel Dirt 13. What is the steepest grade fr any private/interir rad? % 14. Will the prpsed interir rads be ne-way r tw-way? One-Way Tw-Way Bth 15. Hw many parking spaces are prpsed? 16. Are yu prpsing any use identificatin signs? Yes N 17. Are yu prpsing any n-site directinal signs? Yes N 18. What is the prpsed methd f dmestic water? Public Cmmunity Well Individual Well Nne 19. What is the prpsed methd f sewage dispsal? Public Cmmunity Septic Individual Septic Nne 1

2 20. Are yu prpsing shwer/restrm facilities? Yes N 21. Are yu prpsing laundry facilities? Yes N 22. Are yu prpsing electrical and/r ther utility cnnectins? Yes N 23. Are yu prpsing any exterir lighting? N Yes: What Type? 24. Are yu prpsing fire pits and/r barbecue pits? Yes N 25. What materials will the fire pits and/r barbecue pits be cnstructed frm? 26. What are the rfing materials n the existing and prpsed structures? 27. Are yu prpsing a caretaker residence and/r ffice? Yes N 28. Will the caretaker residence and/r ffice be a: Cnventinal Cnstructin Manufactured Hme 29. Will there be any pl/water recreatinal facilities? Yes N 30. What percentage f the facility will be in cmmunity pen space? % Yakima Cunty will make reasnable mdificatins t plicies and prgrams t ensure that peple with disabilities have an equal pprtunity t enjy all f its prgrams, services, and activities. Anyne wh requires an auxiliary aid r service fr effective cmmunicatin, r a mdificatin f plicies r prcedures t participate in a prgram, service r activity f Yakima Cunty, shuld cntact the Yakima Cunty ADA Crdinatr at as sn as pssible but n later than 48 hurs befre the scheduled event. 2

3 NARRATIVE FORM Yakima Cunty Public Services 128 Nrth Secnd Street Furth Flr Curthuse Yakima, Washingtn (509) FAX (509) FINAL Revised 10/01/15 The Narrative Frm is designed t help yu, the applicatin review, interested agencies, and adjacent prperty wners t the prpsal understand the scpe f yur prject and hw yur prject meets the legal requirements in the Yakima Cunty Cdes. Yu shuld refer t the apprpriate sectins f the rdinance when describing yur prpsal if applicable. Yu can btain a cpy f the rdinance in ur ffice r access it n the internet at: Narrative Cntent: Please tell us the wh, what, where, and why f yur prpsal. A list f typical cntent is prvided belw. Please d nt limit yur prject s descriptin t just these items. In rder fr us t cnduct a timely review f yur prject please be as detailed as pssible. Any missing/cnfusing infrmatin culd result in the delay f ur review. Nte: Nt all cntent listed belw will be pertinent t yur prpsal. suggestins in rder t help yu draft yur narrative. These items are Suggested Cntent: Describe the current use f the site including all existing structures with their dimensins, square ftage and usage. Describe the prpsed use in detail (including but nt limited t the type f business and/r use, hurs and days f peratin, number f emplyees, number f peple living n-site, maximum number f custmers and/r guests, changes r additins t the driveways r ther access pints, the type f mitigatin r adjustment requested). Describe which standards are prpsed t be adjusted and justify why the standard needs t be adjusted. Describe any new r existing structures t be used as part f this prpsal. Describe hw the prpsed use will be pertinent t the prpsed/existing structures. Describe any parking facilities (number f spaces and surface type), landscaping, signage, and lighting that will be assciated with yur prpsal. Describe yur access t the prperty and the rute f travel t the site. Fr cmmercial peratins describe the travel ways that will be lcated nsite. Describe the timelines fr cmpletin f yur prpsal. Please remember that yur narrative must explain in detail the specifics f yur prpsal and any missing infrmatin may result in the need fr future reviews. Yur narrative can be typed and printed n a separate sheet f paper with See Attached written belw, r yu may print ut legibly yur narrative n the lines prvided. 1

4 Please use additinal pages as needed 2

5 REQUIRED ATTACHMENT: YAKIMA COUNTY GENERAL SITE PLAN Nte: Prducing the site plan frm this template is preferred, hwever, the template can be substituted fr yur wn drawing (cmputer aided is acceptable). Site plan must be drawn with blue r black ink LOT COVERAGE CALCULATION a) Dimensin(s) f existing structure(s) S.F. b) Building additin/new structure(s) dimensin(s) S.F. c) Existing paved area(s) (driveways, walkways, patis, etc.) TOTAL S.F. d) Prpsed paved area(s) S.F. e) Ttal Impervius Surface (a+b+c+d = e) S.F. f) Lt Size (1 acre = 43,560 sq ft) S.F. g) Lt cverage (e/f x 100 = g) % MAP SCALE (check ne) Preferred Scale: 1 inch n the map = 20 ft n the grund Custm Scale: 1 inch = *Square is 0.20 by 0.20 PARKING CALCULATION (Reference Table in YCC 19.22) Spaces required: Spaces prvided: Surface Type: LOT INFORMATION Parcel #(s): Site Address: BACKGROUND INFORMATION Owner Name: Site Plan Created by: Address: Cntact Phne: ( ) Date Created:

6 Required Site Plan Infrmatin: N/A # 1 Prperty line dimensins f all lt(s) invlved in the prject. The lcatin, width and purpse f all easements (utility, access and/r irrigatin) n the site and adjacent t the 2 site. The distance frm existing and prpsed structures t the centerline f state, cunty, private rads, r access 3 easement with name, dimensin, surface type (paved, gravel r dirt) f rad. 4 Existing r prpsed driveway lcatins Lcatin, shape, size, grss flr area, height and types (i.e., huse, garage, well huse) f all existing and prpsed 5 structures, minimum building setbacks frm the prperty lines and ther structures, and the ttal lt cverage. The lcatin, right-f-way widths, pavement widths, curbs, gutters, culverts and names f all existing r platted 6 streets r rads, whether public r private, and ther public ways within the subject prperty r adjacent t any affected lts; Lcatin f well r water systems within 100 feet f the subject prperty r within a 100 ft well cntrl zne and 7 the distance frm any structures within the well cntrl zne. Label as Individual, 2-party, Grup B, Grup A. Lcatin f prpsed r existing septic tank, drain field area, and extensin area, as well as replacement areas and 8 distances t structures and prperty lines The lcatin and dimensins f any existing and prpsed utilities, streets, railrads, irrigatin and drainage canals, 9 easements and dedicatin f prperty within the subject prperty r adjacent t any affected lts; Critical Areas/Shreline: River, streams, creek, pnd, fldplain, fldway, etc. n r abutting the site (Distance 10 frm structure t the rdinary high water mark f the river, stream, creek, etc.) Shw the existing tpgraphic cnturs at intervals f nt mre than 5 when the grund slpes exceed 10%. Extend beynd the bundaries f the site. Building Divisin Applicatin Site Plan Infrmatin: N/A # 1 Fire apparatus turnarund Fr larger parcels, draw a simple plan shwing the entire lt and indicate which area the new cnstructin is t 2 take place. Attach t the detailed sectin and submit bth. 3 Distance f new structures frm all prperty lines. Planning Divisin Applicatin Site Plan Infrmatin: N/A # 1 Lcatin and dimensins f all prpsed exterir land uses. 2 Lcatin f new and/r expanded public and private utility infrastructure. 3 Lcatin f pedestrian and vehicular circulatin patterns, sidewalks, trails and bicycle paths. 4 Lcatin f structures n the adjining lts, which may cause cmpatibility issues. 5 Prpsed lcatin and dimensins f cmmunity and ther pen space. 6 Existing and prpsed landscaping, site screening, street trees and strm water drainage facilities. The existing n-site sewage system cmpnents and reserve areas and the prpsed lcatin fr n-site sewage systems and sil test pits fr all affected lts nt served by an n-site sewage system r ther apprved 7 wastewater treatment system. The lcatin f structures n the adjining lts when within 100 feet f a well r n-site sewage dispsal system; 8 Prpsed cnturs and grading as they affect lt layut, streets, and drainage ways. Lcatin f adjacent public water, sewer main, fire prtectin systems and ther undergrund facilities within r 9 adjacent t the develpment. Fldplain develpment: Descriptin f the extent t which any watercurse will be altered r relcated as a result f the prpsed 10 develpment. The bundaries f the 100-year fldplain, the bundaries f fldways where fldways have been established, 11 and the 100-year base fld elevatins where base fld elevatins have been established. The bundaries f the 10 and 25-year fldplain using the fld risk maps prvided by Yakima Cunty as part 12 the mandatry pre-applicatin cnference. 13 Other infrmatin as may be required by YCC Titles 13, 16A, 16C r 16D.

7 GENERAL APPLICATION FORM Fr Land Use Actins Yakima Cunty Public Services 128 Nrth Secnd Street Furth Flr Curthuse Yakima, Washingtn (509) FAX (509) (Staff Use Only) Zning District: Date: Receipt #: Reviewed By: Prpsed Land Use: Case #(s): FINAL Revised 03/28/18 CHECK ALL THAT APPLY AND ATTACH THE APPROPRIATE SUPPLEMENTAL FORM(S) Zning Subdivisin Shreline Type 1 Admin. Adjustment Exemptin (SSE) Shreline Substantial Dev. Type 2 Variance Shrt Subdivisin Shreline Cnditinal Use Type 3 Mdificatin Subdivisin (Lng) Shreline Variance Type 4 Nn-Cnfrming Use Binding Site Plan Shreline Exemptin Reduce Resurce Setback Interpretatin Alteratin/Vacatin Shreline Nn-Cnfrming Accessry Dwelling Unit Dairy *Amendment Shreline Minr Revisin Minr Rezne Mining Sub Variance Majr Rezne Critical Areas CA Standard Develpment Other CA Adjustment Envirnmental Checklist Plan/Dev. Reg. Map Ad. CA Reasnable Use Except. Appeal - HE BOCC Plan/Dev. Reg. Text Ad. CA Minr Revisin Develpment Agreement CA Nn-Cnfrming Use Parcel Number(s): A. B. C. Subject Prperty Address: Are yu requesting the Optinal Cnslidated Permit Review Prcess as prvided under YCC 16B ? Yes N * In accrdance with YCC16B (2)(a) please submit verificatin with yur Shrt Subdivisin Amendment r Subdivisin Amendment that the majrity f thse persns having an wnership interest in the lts, tracts, parcels, r prtin theref t be revised r altered has signed the prpsed applicatin. EVIDENCE OF LEGAL AVAILABILITY OF WATER (YCC ) All applicants fr a develpment permit requiring ptable water must prvide evidence f an adequate water supply t Yakima Cunty prir t the issuance f the permit. Check belw the legal surce f water. Water right permit frm Department f Eclgy, r Letter frm an apprved water purveyr stating the ability t prvide water, r **A Yakima Cunty Water Resurce System (YCWRS) dmestic well within the Agriculture zning district, r **A Yakima Cunty Water Resurce System (YCWRS) dmestic well utside f the Agriculture zning district, r Other adequate evidence f interest in a suitable water right held fr mitigatin prpsed by an existing water bank, r Yakama Natin Water Cde permit fr prperties lcated within the exterir bundaries f the Yakama Natin, r Dcumentatin that the well site is lcated utside the Yakima River watershed. Additinal Infrmatin Prir t final apprval, the applicant will be required t prvide evidence f the water quality and quantity in the fllwing frms: 1. A Letter frm an apprved water purveyr stating the ability t prvide water, r 2. Ntificatin frm the Yakima Health District that the water supply is ptable. (wells)

8 **Yakima Cunty Water Resurce System (YCWRS) is a water system rganized pursuant t RCW which prvides service t the public in the frm f mitigated r water budget neutral water supplies fr dmestic use thrugh the withdrawal f dmestic supply frm a grundwater permit exempt well. The service areas f the water system is all f the privately held prperty in Yakima Cunty within the Yakima River watershed except thse areas within the crprate limits f the city, within the exterir bundaries f the Yakama Reservatin, r within the service areas f a Type A and Type B water system in existence prir t January 1, The YCWRS hlds senir water rights and allws the use f such rights by the public when wells are cnstructed and metered accrdingly t YCWRS prcedures. Applicant Infrmatin: (Please check the bx t indicate the primary cntact persn) By signing this frm, the prperty wner/applicant agrees t the fllwing: I hereby state as true that all wnership interests f the prperty have reviewed the prpsal as presented in the applicatin materials and supprt the prpsed change(s) in land use. I hereby give Yakima Cunty permissin t enter my prperty during this review t inspect my prperty as needed. I hereby agree t pay all additinal fees assciated with the prcessing f this applicatin including Hearing Examiner fees, Transprtatin fees r any ther fees that may be assciated with the prpsed prject. I hereby acknwledge that the applicatin fr Subdivisin and/r Land Use Permit with the Yakima Cunty Permit Services Department: Planning Divisin has be filled ut cmpletely. I hereby acknwledge that verificatin f an apprved ptable water supply is a requirement and part f the prcedure t btain a Subdivisin and/r Land Use Permit. I shall prvide Yakima Cunty with prf f an adequate water surce as indicated in Ordinance r btain a YCWRS dmestic well permit. I understand that Yakima Cunty shall be held harmless fr misinterpretatin r misrepresentatin f dcuments t btain my permits. I am aware my subdivisin and/r Land Use Permit WILL NOT be issued until I prvide prf f an apprved surce f ptable water and assciated dcumentatin. (If the prperty is wned by a crpratin r LLC please attach dcumentatin shwing that the persn signing has the authrity t sign n behalf f the crpratin r LLC.) Please Fill Out This Sectin In Blue r Black Ink and Original Signatures nly. Prperty Owner: Day Phne: ( ) Cmpany (if any) Mailing Address: City: State: ZIP: Address: Signature: (required) Date: Applicant/Agent (if different): Day Phne: ( ) Cmpany (if any) Mailing Address: City: State: ZIP: Address: Signature: Date: If there are additinal wners, prvide an attachment in the same frmat and with the same declaratins Revised 4/4/2018 Page 2 f 2