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HomeMy WebLinkAboutBLD2003-01080 Change of Use - BLD Application - 8/5/2003 MASON COUNTY PRE-INSPECTION APPLICATION 426 W. Cedar/P.O. Box 186, Shelton,WA 98584• 427-9670 $se.so DSO Fee Required prior to inspection PLEASE PRINT 1 2y #1 Owner -.)9aw 7/EP/�� �o�r rani 1 ��{�i- Phone# 960- X",V Site Address o7.28l�I ,u�• Ski/,e ,fl�. f City ��/ �� �✓i4 . Mail Address f0o 6 we /YYS City G�e/i ',- St L„ra Zip Applicant z&rje TAlP/e Phone# Applicant Address >Od City &Z4,0 "' St Zip #2 Parcel No. Legal Description7/ TO c j8o/8 9 #3 Purpose of Pre-Inspection e 4,re V e /fj��Ce /'A 7� tie 14 ti / �e� (4 T P We.,- 04 1��/e 2'6pfK/Aa r C/0 99 lk 7�T uJt�r/1 anol M7EeT Aror��c7'rJ De�CnT1 at A�y l-1 lit�P !1Lp� z Q&7 - #4 Use of building P r -� �VY~ one. c)T Pee, spac , dhl #5 Indicate by circling the applicable source if any water is on or adjacent to subject property: saltwater lake creek stream marsh river pond etlan seasonal runoff other Directions to Site: yr 40 &1�^4&T c P OT N a ��.IiA� /J �� P �/�a Aodr 4T ?��P enaP� �Y� ?'��l P �r-r /lC• Show following on the site plan below: Lot Dimensions, Existing Structures, Structure Setbacks, Water Lines, Septic Systems, Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, etc. y T J a0 IiV,P B/ G✓p r� ry/j„�.l7�ra� wi)1j C'�(any p v 4 4 re 1°l��i vn -34, /, o T 3 C C 2 �wl 1-�1�. ` Ott_ ©vim O c,P tj� �l C�eV V V•.O.r�hc�.►--1� �Z ���16v1�Ql� Applicant Signature / lG�i �� _ ____ _ _ _ Date � Rug 03 03 02: 33p Bob a Patten PaMsse 360-427-2353 p. 3 Rk. � 1 - I ` I ! - _ f O�x t 1 t , a I i _, -- -- --- - - -- i ••Imo','/V� _I ,r - ,�. 1 t ^ L���_:'-:�• � � ,eer.- `�' �� r.� r 1 r <. 11-3W