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HomeMy WebLinkAboutBLD2009-00384 Final Garage/Storage - BLD Permit / Conditions - 8/20/2009 ' Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD2009-00384 OWNER: JOHN BYERLY RECEIVED: 5/14/2009 CONTRACTOR: LICENSE: EXP: ISSUED: 6/24/2009 SITE ADDRESS: 370 NE LARSON LAKE RD BELFAIR EXPIRES: 12/24/2009 PARCEL NUMBER: 123312390012 LEGAL DESCRIPTION: TR 1-B OF GOUT LOT 2 LOT: 2 OF SP#2303 PROJECT DESCRIPTION: DIRECTIONS TO SITE: GARAGE/STORAGE W ON HWY 300 FOR 3 MILE TURN RIGHT ONTO LARSON LAKE RD FOR 1/3 MILE ADDRESS MARKER ON RIGHT HAND SIDE ADJACENT TO RENEGADE CAMP General Information Construction&Occupancy Information Square Footage Information No.of Bedrooms: Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: U Lot Size: Deck: Type of Work: ACC Fire Dist.: 2 No.of Stories: 1 Occ. Load: Building: Garage-Detached 624 Valuation: Building Height: Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: N 42.0 Ft. Shoreline: Ft. Water Body: SEPA?: Unkn Model: Width: Ft. Rear: E 200.0 Ft. Slope: 80.0 Ft. Shoreline Desi Side 1: S 10.0 Ft. g.: hWApplicable Year: Sedal No.: Side 2: W 25.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee TIN 5/14/2009 $245.21 B12009000 EH Plan Review TW 5/14/2009 $41.00 612009000 Planning Review Fee TW 5/14/2009 $205.00 612009000 EH Plan Review ADR 5/20/2009 $62.00 S22009000 Building State Fee DLC 6/23/2009 $4.50 S22009000 Building Permit Fee DLC 6/23/2009 $377.25 S22009000 Total $934.96 BLD2009-00384 Please refer to the following pages for conditions of this permit. 1 of 4 CASE NOTES FOR BLD2009-00384 a CONDITIONS FOR BLD2009-00384 1) Ow / t is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 2) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permi on. X 3) All anges "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordi regulation, must be reviewed and approved by Mason County prior to construction. X 4) Prior to final approval, all upland areas disturbed or n rested by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 5) CONSTRUCTION PROCESS TO BE FIELD CORRECTE AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with t e international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspe shall be made prior to requesting additional inspections. X 6) The use, handling and storage of hazaRV51erials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X 7) The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnical report. All applicable recommendations and specifications shall be applied to the development on this site. Any deviation requires stamped written approval from the registered design professional responsible for the report/assessment, and may require special inspection by same. Structures and /or land modifications (grading, cuts fills, etc.) required in the geotechnical report/assessment, may require a separate permit. The geotechnical report/assessment shall remain atta to the approved building plans. X BLD2009-00384 Please referto the following pages for conditions of this permit. 2 of 4 8) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your ro t� 9) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. A. Drainfield/ Reserve requires a 10ft setback from all footing/foundations. B. Peptic tank(s) requires 5ft setback from all footing/foundations. C. N jdation drains within 30ft, down gradient of drainfield/reserve area. X 10) The planw check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or rem approved documents will result in failure of required building inspections. X 11) All appro a plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not a granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Delp n!Er to any further inspections being performed or approvals granted. X 12) Contracto gistration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-8 - . The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 13) Per C -S CTION R905- REQUIREMENTS FOR ROOF COVERINGS- R905.1 Roof covering application. Roof coverings shall be applied in acc rd h the applicable provisions of this section and the manufacturer's installation instructions. X 14) Per 2003 I - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the EBA i wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 C EED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. 15) Appr a ensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X BLD2009-00384 Please refer to the following pages for conditions of this permit. 3 of 4 16) The "approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then ap roval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Bui n artment prior to any further inspections being performed or approvals granted. X 17) Temporary rosion control measures must be implemented to prevent water quality degradatio of t waters or properties. Silt fencing or straw spead out m st be installed and maintained until upland vegetation has become established. X 18) This s ructure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the intern t n odes and Mason County Regulations unless a"Change of Use" permit is applied for, reviewed and approved. X 19) This ructure is approved as un-heated space. If at any time this building is to be used for anything other than what it is approved for, a change of use per t applied for, reviewed and approved prior to the change. X 20) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action Nra period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder a vented action from being taken. No more than one extension may be granted. X 21) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to req st a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Maso 11 ty ordinances and building regulations. X 22) All prope es shall be clearly identified at the time of foundation inspection. X This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described prpXerty and r review and inspection. OWNER OR AGENT: DATE: �zl 0 BLD2009-00384 Please refer to the following pages for conditions of this permit. 4 of 4 co o CONCRETE MECHANICAL MANUFACTURED HOME o CD Footings 1 Setbacks Date By Ribbons Gas Piping r o Interior Date By Interior-Dane By Date By 00 Exterior Date �_ yp Exterior-Date 8 Set-up t_ Point Load J isolated Footings INSULATION Date By = BG!SLAB INSULATION Z Date By Data By FIRE DEPARTMENT Foundation Wails Floors Date By Date By Data By DECKS FRAMING Walls Date By Date By Data By PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic Date By Date By Type- Date By D.W.V DRYWALL Type- Dare By int Brace Wail Date By W Date By FINAL INSPECTION p ni Water Line Fire Seperation N Date ey Date By Date ..�' By p m � Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments w X, CD 0 8 a o' U1 O S CD CD Q FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. PLEASE f eRw iT T""- BUILDING Po PERMIT APPLICATION A80N� pcN• Reu��cv s� b . Cedar- W5 Nf— ?© Zz?'Shelton (360)427-9670 - Belfair(360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANTJNFO TION CONTRACTOR IN OR Owner lonilA Company Name Mailin ddress Mailing Address 1001, City State t�/g Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder' Contractor Reg.# Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to NAe�ptic Existing Septic Connect to Water System Name of Water System, , Well � Sewer System Name of Sewer System PARCEL INFORMATION - 1122 ,Digit Parcel No. # L Fire District Legal Description y Site Address(Please include street na street number and city) /V ECFKIle Lt/l&• - D' tions to site - o oi2 L,VjK may+ •c C Will timber be cut and sold in parcel preparation?Yes o Is property w't in 200'of Saltwater Lake River/Creek Pond Wetlan Seasonal Runoff Strea Slopes or Blu s 15% Is this permit submittal the re lt of a Stop Work Notice,Correction Notice or other enfor ement action?Ye N TYPE OF JOB - New Add, Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL �] Use of Building r1t11Af6rk No. of Bedroom-, N . of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Flo Basement Deck Covered Deck Other S ar a Attached D ache Carport Attached D a h MANUFACTURED HOq INFORMATION - Make Model Year Length Widt Serial No. No. of Bedrooms No. of Bathrooms Type of Heat rchase Price$ Replacement Unit? Yes/No Installer Name Certification No. OWNER/BUILDER Aci4owledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all art in interest regarding this application or the work n easement holder or an other9 9 PP the necessary parties. If permission is required from any Yparty proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the informaticn provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY M OFAPR �ECTION.I TIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X # Date: I'4 wners Repres tive/Contractor (indicate which one) FOR IAL USE BEYOND THIS POINT Accepted by: Date DEPARTM ENTAL REVIEW APPROVED DENIED NOTES Building Department -72 Planning Department ELL - Environmental Health Department _50C oZ 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 1 MASON COUNTY PERMIT NO t ; T BUILDING PERMIT APPLICATION 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 - Belfair (360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION, Owner ,,,, F , , ,.<, ,, Company Name Mailing Address Mailing Address i Y' --� ; '�' �' City State Zip Code City �� State _Zip Code„ Phone Other Ph. Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address 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 Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel N9,. . '� Z `` '` " N Fire District Legal Description + 7"- Site Address (Please include street name, street number and city) `` %t '��' 7jr, 7 �" D actions to site e.f! 41 kf t° �1 3 t'% =C: $*-1 f 7 r7, ✓&• r? r7: r :l C' �r 1t '.«sfL f:'pt�r c+e. dot ,"{fi3ta i c3 ✓s{eM1 fart Will timber be cut and sold in parcel preparation?Yes o f Is property within 200'of Saltwater f '%'' ' Lake :141 River/Creek ' Pond d Seasonal Runoff ' + Strea �t�r Slopes or Bluffs 15% A.J Wetland Is this permit submittal the re ult o a Stop Work Notice,Correction Notice or other enforcement action?Ye o TYPE OF JOB -,New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building ` rk No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor—Basement—Deck Deck Other -S, ---�- Garage ' ° Attached _____ betacheg- �-- Carport Attached Detached MANUFACTURED HO SINFORMATION - Make Model Year Length Widt erial No. No. of Bedrooms No. of Bathrooms Type of Heat , ` Purchase Price$ Replacement Unit? Yes/No Installer Name Certification No. OWNER/BUILDER Ac owledges submission of inaccurate information may result in a stop work order or permit revocation. j Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all i the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above lion. This permit/application becomes null & void if work or authorized construction is described property and structure for review and inspec not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PRQaRES^IWECTION.INA61TIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. s � X � ;..r, .- Date: Ownerat wners Represe tative/Contrac r (indicate which one) FOR 0FF6AL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department f Environmental Health Department rj 20 " Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee O OC�- Plumbing & Base Fee Plannin Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO. ,! � C �. k BUILDING PERMIT APPLICATION fie N '«� '?17, / 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 /l/E 7� zz Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLI ANT FORMATION CONTRACTOR INFOR Owner Company Name Mailin Address Mailing Address City State ttl14Zip Code City State Zip Code Phone - - Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to Ne Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 1122 Di it Parcel N , 4,7# Fire District Legal Description Site Address(Please include street narrA street number and city) AAC 37414K' N EC -i41lQ WR D tions to site t&Z I 34d -; $-11, u 04- 12 ate, #4 le ern At �' w► Will timber be cut and sold in parcel prep ration?Yes 6510 Is property w t in 200' of Saltwater &44Lake River/Creek Pond Wetland Seasonal Runoff Strea Slopes or Bluffs 15% AZ ZA4- Is this permit submittal the rgAulto a Stop Work Notice,Correction Notice or other enfor ement action?Ye o TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Buildin .• rtM�>,Pd6rk No. of Bedrooms N . of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Floor Basement Dec Covered Deck Other S ar a Attached D;ia`chea.Z Carport Attached Detach MANUFACTURED INFORMATION - Make Model Year Length Widt HO Serial No. No. of Bedrooms No. of Bathrooms Type of Heat rchase Price$ Replacement Unit? Yes/ No Installer Name Certification No. OWNER/BUILDER Ac owledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of su is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the informaticn provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY M OFAPR ECTIONVITIVITYOF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. X Date: Q57;—e8-190 r"avomwners REpresjqt tive/Contra! r (indicate which one) FOR IAL USE BEYOND THIS P6tNT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department rl0• 3 Planning Department ELL A 5- 00 Environmental Health Department 5NCO oM —enwAj Marshal FEES Building Permit Fee j 7 . Site Inspection Plan Review Fee a EH Review Fee Plumbing & Base Fee � Planning Review Fee Mechanical & Base fee D Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee A- I -9:9;' Pre-Paid at Submittal oZ Valuation $ 619 X = ac3�37 0`3� TOTAL FEES MASON COUNTY PERMIT No. A BUILDING PERMIT APPLICATION ;4 {' 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 /146 = 7 0 Shelton (360) 427-9670 - Belfair(360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICAN NFQR TION CONTRACTOR INFOR IA Owner c- Company Name +� Mailin `Address � JX 1 5 Mailing Address ?" City Statet#�✓i Zip Code City State Zip Code Phone{ - -.,/ 3'6 Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to,Ne Septic- Existing Septic Connect to Water System Name of Water System m , Well '" Sewer Syste Name of Sewer System PARCEL INFORMATION - 12 Qigit Parcel It— N G Fire District Legal Description - Site Address(Please include street naA, street number and city) 1)141 r4 bir IV& l fW.,J VIA- D' ctions to site uj 4 � t�J 4e k vl Sour K o >► f 9 !'k'r.ke wAV w ;S f cter f4 r°.Errt* N -• Will timber be cut and sold in parcel prep ration?Yes o � // ,,��� Is property it in 200'of Saltwater ,V Lake River/Creek r Pond Wetlan Seasonal Runoff�`/ Strea t Slopes or Bluffs 15% Is this permit submittal the r ult dt a Stop Work Notice,Correction Notice or other enfor ement action?Yo No TYPE OF JOB - New—.Add,, Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Buildin`f E4© f1 p`t _I1W 1 *dbrk No. of Bedroom I No. of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Flo2r Basement Dec Covered Deck Other arage Attached Detache Carport Attached Detach MANUFACTURED HO INFORMATION - Make Model Year Length Widt Serial No. No. of Bedrooms No. of Bathrooms Type of Hea 2= Purchase Price$ Replacement Unit? Yes/ No Installer Name Certification No. OWNER/BUILDER Ac nowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of su h is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work 1 proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEAN$OFAPR SlN PECTION.IWtqTIVITYOFTHISPERMITAPPLICATIONOF180DAYSpWILLINVALIDATETHEAPPLICATION. X Date: .r '^+�i�l'"�✓'� C wners Repres tive/Contra or (indicate which one) FOR IAL USE BEYOND THIS PO NT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department J Environmental Health Dep rtment sLkj cl a Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee 4 Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee I Violation fee Pre-Paid at Submittal Valuation $ TOTAL FEES i FORM MUST BE COMPLETED IN INK I I 7 PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION I Case No. Name ✓1 PARCEL NUMBER M 33/ 23 9001 Z_ Date GS=0 k 610 SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E,W in relation to the site plan i i of Dimensions /OFences 'Existing Structures Driveways tructure Setbacks ,MIrkShorelines A 1 Water Lines —�fopography / Well Location (including adjacent) Plan VJ Names of streets r--Easements arty 'Names of Fronting Streets ✓§eptic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of scent y line. adjacent property line- , (-adjac p rOD line e I W 1 ZLt r 1 _ I I i 1� PROVED �s MASON OOUNTY DCD PLANNING SITE PLAN REQUIRED TO BE ON SITE CHANG&S SUBJECT TO APPROVAL By I Date I 1 i 1 adjacent property lined 1 �a -t w1p � �''�Y ttiy4- (-adjacent property line i SAMPLE SITE PLAN adja�nt property fine-� aio' Fadjacent property line D 30" rrtEscRvG mil -%6A-3G N AL 1 a 1' ti CREEK. � I n I HOMtr i .GGatN � MousG. I j PrA4Paun %aP+r I. < I K— 60' ISO* it I R I . VAGNT 1 n,nrtAr.� \ I I 30• I ,y�� �.PaoPmca 5o' A611SGLLLTu.RAL 1. �. Edo'—mil 1 \ I I 1 `"-eLL 1 I i 1 1 1 /00. 1 adjacent pro ert -lined ; / c Fadjacent propert7y 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.) FORM MUST BE COMPLETED IN INK 10 3 70 PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION Case No. Name h PARCEL NUMBER 6?33/ 23 gQ0J Date E-14 I SHOW THE FOLLOWING ON SITE PLAN Show Direction by indioationg N, S, E, W in relation to the site plan of Dimensions 11/+fences xisting Structures Driveways tructure Setbacks 8(r+Shorelines ,�1 Pater Lines ✓topography Well Location (including adjacent) 1-6rainage Plan `Q UJ Ry Names of Streets vEasements ames of Fronting Streets ✓Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of scent y line. adjacent property line- I FadjaSc pe ' on line � d` Z�/L8 w IVI I I - - 46' uA I N 11X�ST I I � I I I I I I I 1 adjacent property lined I 7►2w ✓r�` 'r `�' w � <-adjacentproperty_tine SAMPLE SITE PLAN adja�nt property line-� I v 3io' 30. rRE3cavE E-adjacent property line gF�SO U AL. fi 3 CR�K \ i \ I Hon+tr I Gn`au jPrtoPostD -&P+tc --�I I 14— 60• —/So �I I I VAGtuT � fi G,ARAt.� I �� 30. I P0.oPmC0 50 --�jl I �k AbRSCta.LTu.RA.L I � I / 1 I , I � I ioo' I i � r"•eLL I I I I I I --/00. I .O I adjacent roe line--.* <-adjacent pro peril 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 dy s+a«.c�. fin r c 7: ee-/ � diaiFa�ca_ Signa D to