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MASON COUNT' ',,_."_ �
PRE-APPLICATION CONFERENCE WQUEST FORM
The purpose of the pre-submission conference is to identify and/��r��ee}i A UkUb potential problems as
possible in order for the project to be processed without delay. Repmser G s or the Fire Marshal's Office, Building
Department, Environmental Health, Planning, and Public Works Departments may attend the meeting to discuss rules
and regulations applicable to the proposed project, Topics covered during the meeting will include the comprehensive
plan, shoreline program, zoning, availability of sewer and potable water, development concepts, building construction,
fire protection and life safety concerns of the proposed project.The pre-submission conference will be most informative
when you provide accurate and detailed information on the Pre-Application Conference Application Form and the site
plan. Applications will be accepted when all information is received and deemed complete.
Pre-Application Conferences are held every Wednesday and last one hour. To schedule a meeting complete the
application on both sides and return 10 copies of the detailed site plan, along with S205.0o fee, by Le PM on the
Wedtnesday prior to the proposed Wednesday meeting to the Mason County Department of Community Development,
ATTN: Pre-Submission Coordinator, P.O. Box 186, Shelton, WA 98584. Fax request forms to (360) 427-7798. If you
have any questions call (360)427-9670 ext.281.
Date of Request: Site Plan
Applicant: Submit 10 copies
Name: M-R Include the following informcmon
Mailing Address: W, S' on site plans:
Daytime Telephone: - HO:L 0 Indicate Scale and North Arrow
Representativ ' ❑ Property]me dimensions,easements,
Name: 0�//. ec,/ =d right-of-ways.
Mailing Address:__ ❑ The location of all existing and
Daytime Telephone: roc d��•Include sgaam s
proposcd
Parcel Number: 12 digits b'tnretu7eb.
zD I(Z _ 3 oo U 0 Setback(hstance,in feet from all
propertylmes and structures.
Description of Project: 0 Ustmg and proposed road access to
Include: 1)Square footage of structure,2)Use of building and rooms(i.e., and him the site_
office,warehouse,restaurant, storage, etc),3)Occupancy classification per 0 Parlang sites
IBC, Section 302.1,and construction type.4)Provide two sets of plans,if ❑ Location of on-site sewage tanks and
available.Use separate sheet if necessary drainfields.
0 .Location of drinlang water supply,
O y Include location on the proposed she
12 /V)S) a and aurrounding parcels,
0 Steep bluffs,wetlands,streams,and
bodies of water
0 Location of fire hydrants and
emergency vehicle access roads,
including grade.
Q Surface and storm water run-off routes.
LFLANNWGloFtAR&LLya 'RESUBMISSION—FM
MASON COUNTY FIRE MARSHAL
>�mum= Mason County Bldg.III 426 W Cedar St
PO BOX 186 Shelton,WA 98584
(360)427-9670 Ext.273
CODE ENFORCEMENT FIRE INSPECTIONS FIRE INVESTIGATION PUBLIC EDUCATION
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PRE-APP CHECK LIST
pLI„i v y ORS PAR# ,: F to — 0o6 9-h
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• Construction Type
• Occupancy T e/Load
P Y YP
• Water Supply & Fire Hydrants k7f
• Fire Flow
N,4 .
5
• Emergency Vehicle AccessFA ` �du spt5
• Addressing iG ioT IW /1 if 2 -
• Exits
• AFA
• Sprinkler System
• Fixed Fire Suppression System
• Fire Extinguishers
• Knox Box
• Storage/Type/Height
• Gas Meters/Tanks
• Other
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Has the project been discussed, g a previous Pre-Application Conference: If yes,please indicate date.
Will the building have employees? If yes, how many? �r
What is the water availability of the proposed project? If there is an existing well, what is the name of the
system?
What is planned for the on-site sewage system?If you are proposing a new on-site system provide detail on the
required site plan.
APPLICABLE BiTMDMG CODES
2003 Intemational Building Code/2003 International Residential Code
Uniform Fire Code-ANSI A 117
2003 International Mechanical Code—WAC 5142
2003 Uniform Plumbing Code—WAC 51-56/51.47
2003 Washington State Energy Code—WAC 5 1-11
2003 ventilation and Indoor Air Quality Code—WAC 51-13
Mason County Ordinance
To be filled out by Coordinator � �.� I No
I:PLANN04GZCHARE L L&RFNEE\PRm uB MLSS ION,FRM
UZ/ZJ/ZVUO 13:J3 YAA JOU 497 77V6 MASON W YEKAHT C:1K 4004
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NON RESIDENTIAL DEVELOPMENT
INITIAL REVIEW QUESTIONNAIRE
In accordance with Washington State's Growth Management Act, the Mason County
Comprehensive Plan regulates the placement, expansion or modification of commercial, industrial
and public facilities to certain areas of the county. In the interest of saving you time and money the
Department requires this initial review checklist to be completed and reviewed by this department
prior to the submission of any building permits.
Applicant Namur Daytime Phone # QD-o32-1
PP yh U
Mailing Address Z-4)00 Cj /by ej .
Site Address
Directions to Site /-0/V -�-LiZJ-4.✓ /Q JPo�� �o
Septic-4 _or Sewer
Water Supply bjw
Tax Parcel Number # -4215 - ll - 3a
Legal Description l J lZ. DF E YL IDC S w
Type of Development 6)4
Applicant's Signature 6jja��,
OFFICIAL USE
IUGA Approved By
Existing Coa menial Date
CONDITIONS:
DIRECT NO ADDITIONAL DRAINAGE TO COUNTY RIGHT-OF-WAY
N DO NOT BLOCK OR FILL IN NATURAL DRAINAGE AREAS
ED PER 2652_39
14 PAGE 21
YS - N 85_56'12_E -—------
-----_- -T\"
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FOUND 314" PIPE N
S 31 2322" W, 1.77
FROM PROPERTY COR. �
SHELTO_N_MATLOCK ROAD_______--------_��__ ---- -- - —`_- - 2615.66 _------
_
---- 327.01
FOUND 3/4" PIPE i
654.02 1 130,533 ft2 u S 2856'46" W, 1.55
2.997 Acres FROM PROPERTY CON.
30' EASEMENT FOR—►i. o O T 1
INGRESS, EGRESS i rxu.
AND UTILITIES 1 v
FENCE INTERSECTION
°' S2'12'02"W 182.72'
Ir `� N FROM PROPERTY CORNER LEGEl�
o
FENCE CORNER 1 -+
S 1 42'06" W, 248.52' j FENCE INTERSECTS
FROM PROPERTY CORNER xs 3v PROPERTY LINE
85'57'21" E O
325.65
3 i3
302,714 (t2 r It N
0 6.949 Acres o `� ^
V) LOT 2 . � ��
(M)
ENCE INTERSECTS
cw M PROPERTY LINE 1 (R)
of �
m
i
1
i
FENCE INTERSECTS
PROPERTY LINE c`
FENCE COR. v
N 64'0523" W, 20.4 1
'0FROM PROPERTY CO
PER oi
PAGE 21 3 322.47 2-—- --- 5_7
644.94
____ 17.73
--"--------31.03 N 85'58'S0" E
REFERENCE S
VOL. 14, PG. 55 OF S
EQUIPMENT. VOL. 7 PG. 135 OF S
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