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VAR2006-00022 SPI2004-00311 SPI2002-00021 - VAR Letters / Memos - 6/24/2006
�pgON oo MASON COUNTY Shelton (360) 427-9670 DEPARTMENT OF COMMUNITY DEVELOPMENT Belfair (360) 275-4467 Planning Mason County Bldg.1 411 N.5th Elma (360) 482-5269 _ P.O.Box 279 Shelton,WA 98584 August 29, 2006 The Coot Company ATTN: S. Shanewise 416 S. Washington Olympia, WA 98501 RE: Variance Request(VAR2006-00022) Dear Mr. Shanewise: After reviewing the Habitat Management Plan(HMP)submitted with Don Cline's Variance application, Mason County Staff has determined that it does not fully meet the requirements set forth in the Mason County Resource Ordinance 17.01.110 J. Specifically, • An analysis of the effect of the proposed use or activity upon fish and wildlife species and their habitats listed in this ordinance(17.01.110.J.2.b). In other words, in your HMP, please include the species of fish known to use the subject stream. Also, it would be helpful if it is more specific about how many and what species of trees(greater than 5"diameter ABH)will be removed for the proposed project. To avoid postponing the Hearing date,the revised HMP should be delivered to the following address by September 5,2006: Mason County DCD ATTN: Rebecca Hersha, Planner P.O. Box 279 Shelton WA 98584 Or you may email it to Rebecch@co.mason.wa.us. If you have any questions, don't hesitate to call me at (360)427-9670,extension 593. Thank you. Sincerely, i Rebecca Hersha, Planner Mason County Department of Community Development cc: Don Cline, 3 is .13,t 00% co MASON COUNTY � Shelton (360) 427-9670 DEPARTMENT OF COMMUNITY DEVELOPMENT Belfair (360) 275-4467 Planning Mason County Bldg.1 411 N.5th Elma (360) 482-5269 P.O.Box 279 Shelton,WA 98584 54 4,,4 MEMORANDUM DATE: July 24, 2006 TO: Gloria Rogers, WDFW John Konovsky, Squaxin Island Tribe FROM: Rebecca Hersha, Planner RE: A Variance from the Mason County Resource Ordinance (RO)No.77-93. The Fish and Wildlife Habitat Conservation Areas chapter of the RO requires that a variance be accompanied by a Habitat Management Plan. A Habitat Management Plan prepared by The Coot Company is enclosed for your review and comment. NOTE: Please find the enclosed Habitat Management Plan for your review and comment. Mason County Resource Ordinance Fish & Wildlife Habitat Conservation Area Chapter 17.01.110 provides that management plans shall be reviewed by local Tribes, Washington State Dept of Fish and Wildlife and other applicable state/federal agencies. A 28-day comment period is provided. Details of the project follow: Site Address: Lots 137, 138, and 139 of Lake Limerick, Division 4. On E Dartmoor Dr., Shelton, WA 98584. Applicants: Don Cline Legal Description: Township 21 N, Range 3 W, Section 27, Washington of Mason County. Parcel No. 32127-5 00137. Project description: Construct a single-family dwelling (2700 sq. ft.) within Cranberry Creek's buffer, a Fish & Wildlife Habitat Conservation Area Type 1 stream. The structure's closest point to the stream is 85 feet. Mason County's Resource Ordinance requires a 150' buffer plus a 15' foot setback for Type 1 streams. Please submit comments by August 23, 2006 to the address above, ATTN: Rebecca Hersha. Or you may email your comments to RebeccH@co.mason.wa.us. Please feel free to contact me if you have any questions. I can be reached at 427-9670, ext 593. LIST OF ADJACENT PROPERTY OWNERS** WITHIN 300 FEET OF YOUR PROPERTY BOUNDARIES FOR VARIANCE REQUEST **Addresses are to be obtained from the Mason County Assessor's Office, Bldg. 1,Second Floor. ems/! �� lOd ✓ Qy 1� 73t � S �•�� �- ���-� � ilk �� � ��Y�� � �z� -�'-�,�-�, ���n�-✓ ,KR�d�, - a � l ✓Z'ar�� �ro ✓a , d 12-1 �'Gf /1't -�' �3� /} ( � a v► V�!�'I C �C/ rL adz q / 8 \\CLUSTERI_HOME_SERVER\HOMEICOMMON\PLANNING\Variance Application 2005.doc Y LIST OF ADJACENT PROPERTY OWNERS" WITHIN 300 FEET OF YOUR PROPERTY BOUNDARIES FOR VARIANCE REQUEST **Addresses are to be obtained from the Mason County Assessor's Office, Bldg. 1,Second Floor. /33 12,4 -Ttom✓ /� J--7 � 7-el �L.C/ �70 ✓ AL- PIZi — W uAU3 �70 q0 q J A,( i31� �unK� . '� ► l97 �.7zu �1 T-S 70 lql _cLt4 vq 4 \\CLUSTERI_HOME_SERVER\HOME\COMMON\PLANNING\Variance Application 2005.doc LIST OF ADJACENT PROPERTY OWNERS" WITHIN 300 FEET OF YOUR PROPERTY BOUNDARIES FOR VARIANCE REQUEST *`Addresses are to be obtained from the Mason County Assessor's Office, Bldg. 1, Second Floor. 11E - 1-6 /ryl O'c ' Ire 4o �t 3� t14 7�,Sd /I G �3 7 1 Lg Alif y/-Yu r jurY, ,Saks J \\CLUSTERI_HOME_SERVER\HOME\COMMON\PLANNING\Variance AppYication 2005.doc 1 MASON COUNTY Shelton (360) 427-9670 DEPARTMENT OF COMMUNITY DEVELOPMENT Belfair (360) 275-4467 Planning Mason County Bldg.1 411 N.5th Elma (360) 482-5269 _ P.O.Box 279 Shelton,WA 98584 54 Notice of Application for a Variance from the Mason County resource Ordinance Notice of Public Hearing Notice is hereby given that Don Cline, who is the ap lip cant for the following proposal, has filed an application for a Variance. The request for a Variance from the Mason County Resource Ordinance No. 77-93 is for the construction of a 2700 square foot single-family residence within a type 1 stream buffer. Property location is on E Dartmoor Dr., Shelton, WA 98584. Lots 137, 138, and 139 of Lake Limerick, Division 4. Date of complete application: July 25, 2006. The proposed development is reviewed as a Variance under the Mason County Resource Ordinance No. 77-93, specifically Section 17.01.110 D. 1., Fish and Wildlife Habitat Conservation Areas, which details type 1 stream buffer requirements and Section 17.01.150, Variances from Standards, which establishes Variance procedures and criteria. The proposal requires a Habitat Management Plan, and Hearing Examiner approval. Any person desiring to express their view or to be notified of the action taken on the application should notify in writing of their interest by 1:00 P.M. September 12, 2006: REBECCA HERSHA C/O MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT PO BOX 279 SHELTON, WA 98584 A PUBLIC HEARING will be held by the Mason County Hearing Examiner on the proposed project on Tuesday, September 12,2006 at 1:00 p.m. in the County Commissioners Chambers, Bldg. I, 411 N. 5t' Street, Shelton, WA. Please contact Rebecca Hersha of the Mason County Department of Community Development at (360) 427-9670, ext. 593, with any questions or comments on this development and variance. A decision of this application for a variance will be made within 120 days of the date of the complete application. VARIANCE REQUEST Publication cost is the responsibility of the applicant. Final permit processing will not occur until advertising fees have been paid to the newspaper by the applicant. The Shelton-Mason County Journal will bill the applicant directly. I / WE understand that I / WE must sign and date the attached acknowledgment indicating and that I / WE understand that is MY / OUR responsibility. I / WE must submit the signed page as part of application in order for it to be considered as complete. OWNER: V CL APPLICANT: DATE: \\CLUSTERI_HOME SERVER\HOME\COMMON\PLANNING\Variance Application 2005.doc Lake Limerick Country Club 790 East Saint Andrews Drive Shelton,Washington 98584 (360)426-3581 Fax TO gE KEPT IN THE (360)426-8922 November 10, 2006 `` :__.E Don and MaryBeth Cline 3204 Cain Rd. S.E. Olympia,WA 98501 a--sv vy. 4JW_ Dear. Mr. &Mrs. Cline; The Architectural Committee of Lake Limerick is charged with the responsibility of assuring the proper development and maintenance of our community to the end that all lot owners have the full use and enjoyment of their property. As you know, each owner agreed upon purchase to abide by the By-laws, and Covenants Conditions and Restrictions of Lake Limerick Country Club. The architectural committee received your letter of information for construction in Division 4 Lots 137, 138 & 139. Parcel consolidation of the three lots is a county process, however Lake Limerick will still assess for three (3) lots for dues,water and assessments as they occur in the future. Lake Limerick setback from water is 50 feet; anything greater than fifty (50) is again a county situation. Lake Limerick setback from the road is thirty feet(30),not the twenty you quoted from the county. At this time Lake Limerick will require the minimum of thirty (30)feet. Lake Limerick will require an application to remove any utility easement. The architectural committee meets the second Saturday of each month, if you have questions or comments. Thank you for your cooperation in this matter. Sincerely, l�-'�111 SSZ OIL, Theresa Taylor Architectural Secretary LAKE LIMERICK COUNTRY CLUB (1) Where, in the case of 3 contiguous lots, the outside 2 lots each are increased in size by a portion of the middle lot. In the event, VI-b relative to one single family dwelling would hold permitting only 2 houses on the 3 lots. (2) Where in the opinion of the Architectural Committee, a division of a lot would not be detrimental to the neighboring lots or the Tract. b. No building, structure or improvement shall be constructed, erected, altered, placed or permitted to remain on lots in this Tract, EXCEPT as specifically permitted elsewhere in these restrictions, other than one single family dwelling per lot designed for occupation for not more than one family together with appurtenant outbuildings provided however, that if and while two or more of said lots in said Tract or portions thereof having a combined area equal to or greater than the original area of either of said lots which are contiguous are held in the same ownership and only one main residence is located on said combined area, the other lot or lots or portions thereof may be used for private out buildings and grounds appurtenant to such main residence. Land owned by the Lake Limerick Country Club including the Green Belt areas may have buildings as may be permitted by said Country Club and the Architectural Committee. c. Outbuildings or garages erected and maintained upon on any of said lots or building sites shall conform generally in architectural design and exterior material to the finish of the dwelling houses to which they are appurtenant, and may be, but need not be attached to said dwellings. d. There shall not be erected or maintained on lots in said Tract any residence which shall have a living area on first floor of less than 600 square feet, exclusive of carports, garages and covered porches unless approved by the Architectural Committee, and as pertaining to and excepted in paragraph (e) below. No building shall be erected nearer lfian 30 feet from street lot,fees and must maintain side lines of S feet---EXCCPT that roof lines may extent to 3 feet from side lot lines On stream lots, no building or structure shall be erected, located or maintained nearer than 50 feet from the waterfront lot lines---EXCEPT that an uncovered porch may extend an added 8 feet toward the stream lot lines. e. Mobiles----Trailer.: (1) Mobiles and trailers will be permitted in Division IV of Lake Limerick. Only one mobile or trailer will be permitted on any single lot. Age and type of mobile or trailer must be approved by Architectural Committee. (2) They must be situated in the lots with the Blowing setbacks from lot lines ii. 10 feet minimum from sidelines where subject lot abuts another lot. X 30 feet from any rear lot line---EXCEPT that if said lot is bounded on the rear by a stream, than a 50'setback from the stream edge will rule. Iv Where a stream abuts the side line of a lot, the mobile or trailer must be situated at least 30'from said stream. (3) Natural screening must be maintained as much as possible with a minimum of clearing. (4) Outside clothes lines will not be permitted where objectionable to the Architectural Committee. (5) Septic tanks must be installed;and in the same manner as would be installed for cabins or homes and approved by the Mason County Heald Department. f. A shed, tent, garage, trailer or other outbuildings may be used as a residence temporally or permanently with the approval of the Architectural Committee. g. No building or structure shall be moved onto any land embraced in said Tract from any land outside of said subdivision without permission of the Architectural Committee. h. Until January 1, 1975, no person, except Declarant or its duly authorized agent, or its successors in interest, shall erect or maintain on any said part of said Tract or any lot or building site, any sign, advertisement, billboard, or other advertising structure of any kind, EXCEPT that an owner may place his own "For Sale"sign on his property, and a builder may place his sign during construction and subsequent offer for sale. Signs may be placed upon business buildings The Architectural Committee will approve the type and number of signs L No fence, wall or hedge shall be planted, erected, located or maintained upon any of said lots in such location or at such height as to unreasonably obstruct the view from any other lot or lots in said Tract. The Architectural Committee shall have the power and authority to modify the conditions and restrictions contained in this subdivision (i) of paragraph VI as to any lot in said Tract, if said Architectural Committee, in its absolute discretion, deems it necessary or advisable to do so. Fences sfi "nat be ram,/ocated or maintained on any lot Peaw Man 15 feet to s Ahe,.,AND, on the stream-front lots, no nearer than 50 feet from the stream front lot lines j Construction of docks or other structures extending into Lake Limerick or into or over any body of water or stream must be approved by the Architectural Committee. oN-STATE MASON COUNTY o P� A a N DEPARTMENT OF COMMUNITY DEVELOPMENT > S N Planning Division z� N y ti P O Box 279, Shelton,WA 98584 (360)427-9670 1864 Site Inspection January 07, 2005 DON CLINE 3204 CAIN RD SE OLYMPIA WA 98501 Case No.: SP12004-00311 Parcel No.: 321275300137 Project Description: DETERMINE BUILDING SETBACKS FROM WETLANDS Dear Applicant: Pursuant to your application, a site pre-inspection (SPI)was performed on your property. Below you will find comments made regarding the proposed development and its critical values. In some cases, setbacks for development from shorelines, steep slopes, streams, and wetlands must be included in your specific proposal; these setbacks are included as part of the comments listed below. This information is based on County and State regulations as they exist to date. These regulations may change and may affect the requirements for development of the subject property. Please contact me at(360) 427-9670, ext. 365 if you have questions. Sincerely, Allan Borden Land Use Planner Mason County Planning Department 1/7/2005 1 of 3 SP12004-00311 Site Inspection r 1/7/2005 Case No.: SP12004-00311 Comments: Site inspection of Nov. 24, 2004 for Don & MaryBeth Cline for lots 137, 138, and 139, Div. 4 Lake Limerick: The purpose of this inspection was to determine applicability of planning regulations to site. The subject parcels are located in the Lake Limerick subdivision along Cranberry Creek, a type 1 stream in an area of several bends in the creek alignment. The properties slope slightly downward from the roadway, to native tree and shrub cover largely undisturbed. A type 1 stream is a perennial water of significant volume and fish bearing capability. Mason County Resource Ordinance A designated Type 1 stream falls under the jurisdiction of the Fish and Wildlife Habitat Conservation Areas Chapter (17.01.110) of the Mason County Resource Ordinance. These provisions establish buffers and building setback requirements for streams; for a type 1 stream there is a 150-foot vegetation buffer and a 15 foot building setback, for a total of 165 feet from the channel migration zone (CMZ). In accordance with the Resource Ordinance, buffers are to be retained in their natural condition. New residential development is not permitted within Fish and Wildlife Habitat Conservation areas or its buffers, except for as approved through a variance or reasonable use exception review process. Staff made a measurement along the south property line of lot 137 from the road to bank of creek; that distance is 162 feet. The north half of lot 137 and all of lots 138 and 139 lie within the 150 foot buffer to Cranberry Creek; a small area to the south near the road is within the building setback area . Based on this field review, few areas exist that would not be unencumbered by the critical areas buffer and building setback. The review of a variance from the Fish and Wildlife Habitat Conservation Areas chapter would be necessary to pursue residential development on the three properties. A Habitat Management Plan (HMP), prepared by a qualified biologist, would be required as part of the variance request to support the proposed development. The HMP addresses impacts to the buffer and offers measures to preserve and protect the buffer or to mitigate impacts of the development proposal. A copy of the Fish and Wildlife Habitat Conservation Areas chapter is enclosed, including details on the contents of an HMP and the variance public review procedure. Application for a variance to these standards does not guarantee approval of the proposed development. 1/7/2005 2 of 3 SP12004-00311 Site Inspection 1/7/2005 Case No.: SP12004-00311 Mason County Development Regulations: The site is zoned Rural Residential 5 (one dwelling unit per 5 acres). Development regulations for this zone set forth a front yard and Road right of way setbacks of 25 feet from the edge of easement. An administrative variance may be requested to reduce this setback as low as 10 feet, if the size, shape, or features of the property constrain development front yard and road right of way setbacks. This process requires application and review at the time of the building permit submittal. In addition, the required sideyard setback on the subject parcels is equal to 10 percent of the lot width, or approximately 6 feet. This setback may be reduced by administrative variance to as low as 5 feet. General process: Future site development must include a site plan, reflecting all of these setbacks from property lines, slopes and stream, will be needed for building permit application submittal. A topographical profile will be beneficial in showing how the development is located in respect to the stream and road. No other critical areas such as steep slopes were identified on site that would have an impact on future development. County Codes referred to can be obtained from the County website at http://www.co.mason.wa.us. 1/7/2005 3 of 3 SP12004-00311 MASON COUNTY J PLANNING DEPT. PRE-INSPECTION APPLICATION 5 LEASE PRINT $205.00 Fee Required 1 �" , d 1. Owner:Doh -1�N4G 1.�2� Cc; 11 'e Applicant: ovt.�,rzr Site Address: 1.i C L,,Meric Applicant Address: 54►n e_ Owner Address: 3 Z04 City: ��' St Zip City:B ►-n St L04 Zip 6561 Phone:_(_) day Phone:_ ) 9J- 9/3q day Phone:_ 36® ) 3,5/7-5y g evening 2. Parcel No. ;*Z 12 J7 - S' - Oo 5 rZ� Parcel No. - Email Address: d e d+-n Q 5'CV1 r ocy4 Legal D scription:1,c-Ke �It �er)C Planner: Oi ._.,#�il!#� f)MJ SAL TS : V 'SiP9ti'l l.p`f' �3 r7 (� SNIP Comp. Pla"t� &r cj kype of Use (/-S Water Body 3. Pu ose of Pre-Ins ection : ' p `�rrn� Q w 1l--e- cL 0 0 e ^ b 'g 4. Use of Building: ►'YIQ 5. Do any of the following exist on or adjacent to property?: slope ( ' saltwater( ) lake ( ) river( ) pond ( ) wetland seasonal runoff( ) other( stream seasonal creek ( ) Directions to Site: S i o K D4 r L�r Ue- 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, or the laws regulating development of the site change after the time of inspection. Applicant Signature: kio"� , Date: 1( ^?- © y If you would like to be on site during inspection, please check here: VV Return application to: Department of Community Development, Planning Division RECEIVED P.O. Box 279 Shelton, WA 98584 NOV Q 9 2004. (360)427-9670 426 W. CEDAR STa Please include a $205.00 check or money order payable to Mason County Treasurer When completed, this form becomes part oft parcel file. FOR OFFICE USE ONLY: Accepted by: %c` (`: Date: Please illustrate below the proposed building site in relation o water&property lines: SRGM/ord/MyDom"entsrryWStuH/Pr-inspection MORE ON BACK SIDE Please illustrate below the proposed building site in relation to water and property lines: a C �CC6 2" , _f r UQyo ry, o r t` V p Oviqzo. 6W\qP--C &,ko otot\5 C4�ceyi+ Wk� Departmental Review (For Office Use Only) Planning Departmen Fi#}ndiTngs: r �r ' `.r i�' ,0 }• "' ,ISM Y h Revised 12-26-2003 SRG i 6 o0 0 w N o_ � �n ti,,9a $ 145 a`s f96 o N � ?•�' pry �a '- ,�' M N �. '. p 197` 144 �,u• rG o �3 S4,o�• 6 � ram, b P. G5 (OE' a. cs � s �a �a.q` S�c•�3, F �49S � ��. �: b�° v+ • �� < S h t: E F. ✓ P ` 120 T3, JS o. 143\y o, 5'10 de o �. 142 r •� 118 122 TA y0 04 TT'4A 43 •, 1x,. o� 5 83•. •a2 ba" 117 8 123 201 Q n Oi' 87 09 N N Nre' N io'St"w u+ zA5.o4` Zo3.aT' ZZ S.00'+ UC 4 116 °� Q 124 g 8 202 p• ; 4.4 Nal 33 _ 2o9•a5' ►92.iv' ao " i � .. , 203�. 125115 584 + �v 18'14'04` •w 29`E • qq r J87.95' c - !4 g 126 86'31'44"E 225.Oc' 217.23' S d Q( - 13 ~ • 12? $ a o o -s 2dDft Ar N A6E 1!gx E ►3ti"4 74 00 co' 2 w 22g.00' o r^� , sat•ST'4g t- 4 ON �N1A•a�-3• y8.9Z' 1130.00' Yy o` 23T' " tj It 0` o. -So 00 12414.. E . n87• lo st"W 242.`,, r 106 w 15o.00, •r 133 •P 108 8 107 o N q s 79•14'57"E v 129 a rg�.9a y� �A µe3.54'4�' N 132 4ti��v� 0 Ts,00' ,S.00 7'f.tl' 131.67' r y� 20, 5 I� s � ��2 208 h � a. 9 .9a 49' ^ 4Q:�tia El+�? ,,` JB• to 6t• 00 131 50.0o $0.00' r30,0o' ao..00' q s 3g.� i9` 10, W �r3i2Q �i• 9;2" ° ON eo tio 'I N N 102 _N 103 104 N 105 Oh 80.00' 80.00 so•00' 135,99, V 58a 31 9i"w , 375.99' _. - 0%% .SraTFo� MASON COUNTY o n - DEPARTMENT OF COMMUNITY DEVELOPMENT S v N Planning Division N v y P O Box 279, Shelton,WA 98684 �o �° (360)427-9670 1864 Shoreline Inspection March 15, 2002 I10J _ WA 9 Case No.: SP12002-00021 Parcel No.: 321275300137" Project Description: Preinspection of lots 136-141 of Lake Limerick Div 4 to discuss potential development on site. Some smaller lots proposed to be combined. Dear Applicant: As part of this department's review of your permit application, a Shoreline Inspection (SPI) was performed on your property. Below you will find comments made regarding the proposed development and its critical values. In some cases, setbacks for development from shorelines, steep slopes, streams, and wetlands must be included in your specific proposal; these setbacks are included as part of the comments listed below. This information is based on County and State regulations as they exist to date. These regulations may change and may affect the requirements for development of the subject property. Please contact me at(360)427-9670, ext. 295 if you have questions. Sincerely, Pam Bennett-Cumming Land Use Planner Mason County Planning Department 3/15/02 1 of 2 SP12002-00021 Shoreline Inspection 3/15/02 case No.: SP12002-00021 Comments: PLEASE NOTE: current regulations affecting land use and water setbacks in Mason County are being revised. Applicability of regulations is determined at the time of receipt of a COMPLETE building permit application. Planning staff met Michael Hardin at site 3/4/02. Staff is still a little confused about which lots will be combined, the following is our understanding, please clarify if your proposal differs: Lot 136 - remain as one lot. Site has existing manufactured home. Existing workshop on same property, which was converted to accessory living quarters without permit, to be converted back to workshop by removal of bathroom facilities. Vacant Lots 137 and 138 proposed to be combined. Vacant Lot 139 and 140 proposed to be combined. Vacant Lot 141 to remain a single lot. Under present regulations as of 3/15/02, It appears you will need a Mason Environmental Permit Variance to Type I stream setbacks, plus a Habitat Management Plan evaluating the site, describing the proposed development and its impact, and recommending appropriate mitigation. The plan must meet the criteria of the Fish and Wildlife Habit Conservation Areas chapter (see enclosed highlighted area. Application materials are enclosed, as well as a fee schedule. The process involves public notice, a public comment period, a public meeting before the Planning Commission, and a public hearing before the Board of County Commissioners. Given the lot depths based on site observation, it is likely a shoreline variance to Conservancy 50ft setback will be required on several lots. It is difficult to give specific information without a proposed site plan to work from. Steep slope and steep river bank will make it necessary to require geotechnical reports by a licensed engineer for all sites. The report must meet the provisions of the Landslide Hazard Area provisions for geotechnical reports for review to occur. This letter addresses only planning issues relative to the Shoreline Master Program and Resource Ordinance. Please contact other departments directly about Health Department issues and Building Department issues. 3/15/02 2 of 2 SP12002-00021 MASON COUNTY ? p D - RESOURCE LANDS & CRITICAL AREAS CHECKLIST'"` PLtcASE PRINT $70.00 Fee Required Applicant: ; V f J(A e �A�'-c� r��1 Parcel No. - Applicant Address: 140 9)34_s r,rP 0A_ City: �c (-�-r�-� St LA Zip 9F57X-r Legal Description: Phone: ( 36o ) 20 - Owner Name (if different from applicant: 5 7 0 0 A 2T M '70 ` D � 5-� � 5�i.3' ' l""t . o f1 t�� r �'t� • r s.._ l'f" Purpose of Pre-Inspection: 2 Pu. Use of Building: Do any of the following exist on or within 200 feet of the property: saltwater lake river/stream pond wetland seasonal runoff slope Dir ctions to S'te: t� /'� (AL4 L; ('r - �60 0 Vn/a- Please illustra a in the box below the proposed building site in relation to property lines, significant natural features, slope grade and direction and topography (or include on separate sheet): b t 1- North Arrow . CA�'D This 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 affect by regulations under the Mascn County Interim Ordinance (77-93). This checklist is an important opportunity for identifying early in the permit process whether there will be any environmental regulations affecting the proposed development. 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 affects the lot evaluated in this inspection. Applicant Signature: Date: / z Return application to: Department of Community Development,Planning Division 411 N 5th/PO Box 279 Shett3r,"•dA 98584 (360)427-9670 Please make checks or money orders payable to Mason County Treasurer When completed,this form becomes part of the permit application. 66'At LE M.,IS )£.995 66'SEI 00'0A ,00'09 00'0B u O 901 .� t►01 £01 Z01 °_ 3 �� 0 N W p u! 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