Loading...
HomeMy WebLinkAboutRLC93-0107 - RLC Inspections - 10/21/1993 E iODI MASON COUNTY Date Received: DEPARTMENT OF COMMUNITY DEVELOPMENT RESOURCE LANDS AND CRITICAL AREA, CHECKUST The following checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Site Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Land Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by regulations under the Mason County Interim Resource Ordinance (77-93)*. This checklist is an important opportunity foridentifying earlyin thepermit process whether there willbe any environmental regulations affecting the proposed development. Owner AR V Y Phone # l� S� Site Address City —T- Owner Address ;a �r,4,,, City tat4AZip_ Tax Parcel No. (Confirm with Assessors Office) ,/,�, ,, ' -�l�_ t24?,. 8 L Legal Description_ .,F Project Description Directions to site (Please attach map) Please provide or attach a vicinity 071ap which aclud cross streets, major roads, creekT, etc. Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas offal and resource lands are available for review at Mason County Department of Community Development, Planning use orry Department. Do any of the following exist on this property or within 200 feet of this property? [] 'm 1. Saltwater shoreline or a lake 20 acres or larger? �] ❑ 2. Rivers, streams, or creeks with year-round flow? %&t w&vd NUA— U4� , ❑ 3. Rivers, streams or creeks with intermittent flow but are within a clearly defined channel? ❑ 4. Lakes or ponds less than 20 acres in size? �] ❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See County Maps for guidance.) ❑ 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for guidance.) ❑ 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) ❑ 8. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any of the following programs: ❑ 1. Agricultural Open Space Taxation Program, RCW 84.33 (� ❑ 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest, RCW 84.34 r RESOURCE LANDS-& CRITICAL AREAS SITE PLAN PLEASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE: ► Location&dimensions of eAsting &proposed property boundaries. ► Approximate slope of tend(grads&direction),topography. ►identify legal access Including,width of all road right-of-ways&easements. ► Location of significant natural features(water bodies,rivers). ► Locate all existing&proposed structures,drainfields, wells &driveways. P. Project description Scale 1"= North Arrow 1 state that I have answered the above truthfully to the best of my knowledge. Applicant/Owner Date FOR OFFICIAL USE ONLY Adjacent property. r h ao (Xia At 4fAas' G� w There 1s a $40.00 application fee for.the Resource Land & Critical Areas Checklist. Make checks payable to the Mason County Treasurer. When completed,this form becomes part of the permit application. -SHORELINE _PRE-INSPECTION APPLICATION_' _, _ j �ajDo- I'o� PLEASE PRINT W.00 Fee Required 1. Owner: "ae- 6&5/1r s Applicant: .r s,k7 s Site Address: Applicant Addres : G'..o Owner Address: City: St dA_Zip 9r,166Z City: St Zip Phone: ( 1 Phone: 1 g9s yn64�- 2. Parcel No. i aaa 9 -,29- 00,99'0 Legal Description: 3. Purpose of Pre-Inspection: �.f snag � t er. ��'� '��- �442;6- --)r� �v� . 4., Use of Building: 5. Is there any type of water on or adjacent to property?: saltwater lake river pond wetland ✓ seasonal runoff other _ �V Directions to Site: L ✓ l` V � , _ I h . If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies in the original application. Pre-inspection reports remain valid only until development changes occur in the vicinity which affect the lot evaluated in this inspection. Applicant Signature: . Date: Return application to: Department of Community Development,Planning Division 426 W. Cedar/P.O. Box 578 Shelton, WA 98584 (206) 427-9670/1-800-562-5628 Please include a $40.00 check or money order payable to Mason, County Treasurer FOR OFFICE USE ONLY: Accepted by: G� �T_ Date: 9-ram-q3 r .i� Departmental Review (For Office Use Only) _CW �ks /©e ms is Planning `'Department Findings: 1/41 P" A A ed ;4- .1�;_ 1 Y jr - 4 - c art C l IS c n