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IV. CITY, COUNTY OR TRIBAL INFORMATION <br /> Washington Administrative Code (WAC) 388-8778-0405(2) requires the provider to consult with the city, county or <br /> tribal legislative authorities in which an applicant proposes to locate as an OTP in order to secure a location for the <br /> new opiate substitution treatment program that meets county, tribal or city land use ordinances.. Therefore, please <br /> provide the following information: <br /> f have determined the proposed location of the OTP: <br /> ❑ Is not within the area of any Tribal Trust Land or Reservation, or, <br /> ❑ Is within the area of the following Tribal Trust land or Reservation. <br /> Tribal Trust Land or Reservation: <br /> Tribal Chair: <br /> Mailing Address: <br /> Telephone: Fax: <br /> E-mail Address: <br /> I have determined the proposed location of the OTP: <br /> ❑ Is not within the incorporated area of any city;or, <br /> ❑ Is within the incorporated area of the following city: <br /> City: <br /> City Legislative Authority: <br /> Mailing Address: <br /> Telephone: Fax: <br /> E-mail Address: <br /> I have determined the proposed location of the OTP: <br /> ❑ Is not within the county; or, <br /> ❑ Is within the following county: <br /> County: <br /> County Legislative Authority: <br /> Mailing Address: <br /> Telephone: Fax: <br /> E-mail Address: <br /> OTP Application Addendum--04/1812017 <br /> Page 2 of 6 <br />