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Home My WebLink AboutCOM2004-00113 Cancelled Sign - COM Application - 5/14/2004 FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT-: PLEASE PRESS HARD BUILDING PERMIT APPLICATION 426 W. Cedar • P.O. Box 186, Shelton, WA 98584 �� 1 Shelton (360) 427-9670 • Belfair (360) 275-4467• Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICAN RMATION CONTRACTOR INFORMATION Owner UJ Company Name Mailing Address 2 87 Mailing Address City State WA Zip Code g City State Zip Code Phone34 D Z7.f= 4�?—Other Ph.27.E.3_f'7s' Phone Other Ph. Lien/Title Holder cAl L Contractor Reg.# Exp. E mail address h c iDe— Ql IIA • c o .", E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. /2332 krd o a osy Fire District Legal Description Site Address (Please include Street name, street number and city) Z 17 E O' +...rtAA Directions to site Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enf cement action?Y No TYPE OF JOB - New Add Alt Repair Other, 57t,VAJ PRIMA NCE ❑ SEAS AL ❑ Use of Building Describe Work No.of Bedrooms No.of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Sq.ft. Garage Attached Detached Carport AttOt ed Detached MANUFACTURED HOME INFORMATION - Make o Year Length Width Serial No. No.of Bedrooms No.of Bathrooms Type of Heat Purchase Price$ Replace t Unit? Yes/No Installer Name Certi n No. OWNER/BUILDER Acknowledges submission of inaccurate informat�'�ppn ma result n a st p work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am thebwrier,own le al representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as propbse�d in the a ication.I declare that I have obtained theEermis- plicsionfrom all the ne ssary parties.If per sion is required from any ent holder or any other party in inte ' a- tion or the wor o sed in a I have obtained permissi rom them to apply for this perm/it and cUMP sed. X ate: %..7 MAY 14 2004 O er/Owners Representative/ ontractor (indicate which o FOR OFFICIAL U E EYOND THIS POINT 426 W, CE ° Accepted by: Planning Pd Ck# ate Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED E D NOTES i Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES �0N-Sr,,TFo� MASON COUNTY s` c DEPARTMENT OF COMMUNITY DEVELOPMENT s°v Planning Division N T �? P O Box 279,Shelton,WA 98584 Z�oJ Y �,o~ (360)427.9670 1864 NOTIFICATION OF INCOMPLETE APPLICATION May 28, 2004 PACIFIC NW SALMON CNTR B Parcel No.: 123325000059 Project Description: SIGN Dear Applicant: You have submitted a permit application (case no. COM2004-00113)for proposed construction or development in the county. Upon review of your application, I have determined that the contents of the application are incomplete or do not provide enough detail for review. Therefore, review of your application will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is submitted and the application is complete, I will continue to process your application accordingly. If the additional information is not provided to the County within 180 days of this request, the application shall expire and no further action on the proposed development shall take place. Please contact me at (360)427-9670, ext. 577 if you have questions. S' , Ri k Mraz Land Use Planner Mason County PI ning Department 5/28/2004 1 of 2 COM2004-00113 NOTIFICATION OF INCOMPLETE APPLICATION 5/28/2004 Case No.: COM2004-00113 Comments: The proposed construction under this permit and under COM2004-00112 are within the stream buffer and setback for j Sweetwater Creek, a type III stream. Per the Mason County Resource Ordinance, the minimum setback from a type III stream is 165', which is comprised of an undisturbed 150'vegetative buffer+ a 15' building setback. The proposal requires a varianc6 from the Resource Ordinance. A Habitat Management Plan (HMP), prepared by a qualified biologist, is required to support the variance request. The HMP addresses impacts to the buffer and offers measures to preserve and protect the buffer or mitigate impacts. A copy of the Fish and Wildlife Habitat Conservation Areas chapter is enclosed. It includes details on the contents of an HMP. Please note that application for a variance does not guarantee approval. The proposal must meet specific criteria listed in the Resource Ordinance. If you have questions or require clarification of these issues, please contact me. 5/28/2004 2 of 2 COM2004-00113