Land Use Application Forms

Application Forms

Site Development Review -- Legal Lot of Record Determination - LLOR Determination is a way to assure that a lot has been properly created under state subdivision law, able to be conveyed, and eligible for development.
Site Development Review -- Buildability Analysis - Buildability Analysis identifes site conditions like critical areas, road setbacks, and permitting requirements for the lot. The SDR Buildability Analysis is required prior to development permit applications that propose construction or other land disturbing activities.
Permit Application /DocumentCenter/View/545(PDF) - The Permit Application form is required for each type of land use application.
Supplemental forms are required for some types of permits (see Supplemental Land Use Forms list below and visit the Building Permits and Inspections page).
- Complete Building Permit Application Checklist (PDF)
- Site Plan Checklist (PDF)
- Sample Site Plan (PDF)
- Source Water Review (PDF) - Used for applications were irrigation water use is proposed or agricultural wells.

Supplemental Land Use Forms

Land Division

Shoreline

Supplemental Shoreline Application (PDF)
Joint Aquatic Resources Permit Application (JARPA) - Link to Office of Regulatory Assistance. The JARPA is for shoreline permits and exemptions. Please include a signed Jefferson County Permit Application form with the completed and signed JARPA.

Home Business

Home Business Information and Supplemental Application (PDF)
Hospitality Establishments (Short-term rentals, bed and breakfast, transient housing less than 30 days).

Cottage Industry

Cottage Industry Information and Supplemental Form (PDF)

Stormwater Management

Stormwater Start Here! guides how to complete Jefferson County stormwater forms so that applicants are better prepared for project submittal.

Stand Alone Stormwater Management Permit Application.
Step 1: Stormwater Calculation Worksheet - Required for all permit applications
Step 2: Flow Charts for New Development & Redevelopment
- Step 2.1 Small Projects may submit Worksheet S. No additional submittal is necessary. Small projects that cannot certify Worksheet S may require engineering. The Small Stormwater packet includes all forms and is a fillable pdf.
- Step 2.1: Medium Projects must submit Worksheets A1, B1, C or equivalent. Reference A1A and B1A show typical permanent and construction BMP's. The Medium Stormwater packet includes all forms and is a fillable pdf.
- Step 2.1 Large Projects refer to Worksheet L to determine worksheet applicability. Large projects must at a minimum submit A1, B1, and C or equivalent. Reference A1A and B1A show typical permanent and construction BMP's.
  The Large Stormwater packet includes all forms and is a fillable pdf.
ALL projects must use the following guidance on site: Construction Stormwater Pollution Prevention Best Management Practices (BMPs) Packet
- Typical rural residential BMPs from the Manual are referenced
- All projects must comply with Minimum Requirement #2 in the 2014 Department of Ecology Stormwater Management Manual.
- Medium and large projects should use this information to complete Worksheet B1 (Stormwater Pollution Prevention Plan or SWPPP).
Commercial projects may use the Small Pilot Infiltration Test (PIT) form to demonstrate infiltration feasibility.
"Low Impact Development" Information and Technical Guidance Manual

Miscellaneous

Conditional Use Permit (CUP) (PDF)
Lifting of Forest Practices Moratorium for Single-Family Residence (PDF)
Pre-Application Conference (PDF) - "Pre-App" request form. Pre-application conferences are required for all Type II, Type III, Type IV and Type V project applications and Type I project applications proposing impervious surfaces of 10,000 square feet or more and/or non-single-family structures of 5,000 square feet or more. Additionally, pre-application conferences are required for critical area stewardship plan applications. Pre-application conferences for all other types of applications are optional, and requests for conferences will be considered by the administrator on a time-available basis.
CASP Pre-Application Conference (PDF)
State Environmental Policy Act (SEPA) Environmental Checklist - The Checklist is only required if the proposal is not categorically exempt from SEPA review. Consult your project planner for information. For details on SEPA and instructions for completing the Environmental Checklist, visit the State Department of Ecology SEPA Unit website.
Waiver from Special Reports
Sign Permit
Temporary Use (PDF)
Tree Request Application Packet (PDF)
Road Setback Variance
Variance (PDF