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HomeMy WebLinkAboutGRD99-0004 - GRD Application - 3/4/1999 MASON COUNTY PERMIT NO.: GIRDI -"" LAND MODIFICATION PERMIT APPLICATION 74 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT IN CONTRACTOR INFORMATION Owner 9c, Contractor Name Mailing—Address F O Mailing Address .a City eh State wAZip Code Sys City Stater/ Zip Code Phone Co y„z�-g';o Other Ph.( Ph.( wn&L42 Other Ph.( Lien/Title Holder en/.9 Contractor Reg.# /�/_f7'cJ� ''r1�/ Address Expiration 16 ENGINEER INFORMATION Name Phone U Address State Zip Code PARCEL INFORMATION-12 digit Tax Parcel No. ems/ f S�' /_�/�/ 1py o/O Fire District Legal Description Site Address(include street name and city `c/,e7 Directions to site: t- /je o f= i Will timber 661t and sold in parcel preparation? (Yes/ o) Is your property within 200' of the following: Body of Water(Name) o-; C Saltwater Lake River/Creek c/ Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Soft compressible soils TYPE OF JOB -Excavation Filling Z Grading Total size of area AC_ Size of area to be cleared on slopes over 10% o Estimated amount of cubicyards /A oo 'i Describe Work 00/,Pce— 7 r..%�i� �!;c/�l ,ar, Z(�,�r iA /d i/7 //R.0C n- 7.4 Z I E f LAND MODIFICATION INFORMATION YES NO Will fill be brought on site? If yes, source n G�► c /�o ,bY 1 Will excavated materials be taken off site? If yes, desti tion 0 CY" Does fill contain potential hazardous materials? 13 Has a soils report been completed on site? If yes, include copy. E3 Will proposal result in redirection of any surface water runoff onto adjacent properties? E3 j Will proposed work alter where storm water or ground water enters or exits the site? o Will quality, quantity or velocity of storm/ground water be altered? 0 �T Will runoff be collected/controlled by interceptors, curtain drains or other collection devices? O Will the land be replanted upon completion? ❑' Will the proposal result in slopes steeper than those currently on site? 0 Is the site within 200' of a designated shoreline? NOTICE: THIS PERMIT BECOMES NULL 8,VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMNIEMdED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TWt AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work ordinance requirements regulating the work for which this permit is issued will be done in conformance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall first obtaining approval. be made without fir obtaining approval. X -- Date X Da FOR OFFICIAL USE BEYOND THIS POINT t /� Accepted by /C _� Date 7 %bmittal Amount Due RD—Receipt No. 'T DEPARTMENTAL REVIEW A OVED DENIED CONDITION CODES Building Department uv, o15Co o15 ojs Planning Department Public Works Department Fire Marshal © FEES Grading Permit Fee Site Inspection Plan Review Fee Other Public Works Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES ..� MASON COUNTY PROJECT SITE INFORMATION Case No. Name� /�/u.f PARCEL NUMBER1506/9 -// 000/0 Date SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences �-cJ Existing Structures Driveways Structure Setbacks Shorelines S Water Lines Topography Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line4 , � ,, I E-adjacent property line I L I I I ,or K w 14 � - EMI I � - AI WI I I I I yl I I � I adjacent property line-- 11 3�o I E-adjacent property line l.^ c SAMPLE SITE PLAN adjarent property line- 3io- _ _ f-ddjacent property line D 30" rR�SCRI, 30�1 .gEASO w/AL I a L _�PT7L__,� ) I c HOME I G136.En1 Crt�K i rw I ) PM0 PoseD So-pt:c ' _ --/30 I I VAGNT I T c,Art�a6 o I 3 / PAoPosCD I \ A&RZCuLTu-JXAL 50 I 80, I R.4 /00" I \ I t_,_.eLL I I x /00' --� ' I L.a�GLL I adjacent property line4 ; ! A~. \i E-adjacent ro ert line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE di S+ar.cQ -to . /QO � shr,a�tt.�YG /00 eel dL ,o i nature Date GARY YANDO,DIRECTOR SON.S Tq TF O o A DEPARTMENT OF COMMUNITY DEVELOPMENT U i o T i PLANNING - SOLID WASTE - UTILITIES N Y y BLDG. I • 411 N. 5TH ST. • P.O. BOX 578 1864 SHELTON,WA 98584 • (360) 427-9670 March 15 , 1999 Mr. Jack Huston 1320 SE Arcadia Rd. Shelton, WA 98584 RE : Grading Permit for Jack Huston, Fill Material from Washington Correction Center Dear Mr. Huston: The Mason County Department of Community Development went out to inspect the proposed dump site for the fill material that was to disposed on your fathers property. Your father identified to us that the material was going to stay out at the prison. If in fact this is the correct information, then you should ask to rescind this application and collect the fees that you have submitted for this permit . Please let us know in writing if you do plan on terminating this permit, so that we can keep our records up to date. If you have any questions pertaining to this letter, please contact Randy Neff, at (360) 427-9670, ext . 363 or Tami Griffey at (360) 427-9670, ext. 356 . Si c rely, andy e f Subdivision Planner cc: Tami Griffey, Building Department Recycled �,c� 's .h HUSTON EXCAVATING 7 commercial • residential VED AF ? 71999 April 5, 1999 'WpSON C, .;'LAWNG DEp7. Mr. Randy Neff, Subdivision Planner Mason County Department of Community Development PO Box 578 Shelton, WA 98584 Dear Mr. Neff: In regards to your inquiry dated 3/15/99 pertaining to my grading permit for fill material from Washington Correction Center, the information given to you by my father is correct. The owners have decided to keep the material on site. I would like to rescind the application and have my fee refunded to me. Thank You, Jack A. Huston Owner i Office&Shop 9 S. E. 1320 Arcadia Rd.•(206) 426-0550 9 Fax(206)427-5835•Shelton WA 98584