HomeMy WebLinkAboutMIS93-0226 Cancelled Demo - MIS Permit / Conditions - 7/6/1993 MASON COUNTY
DEMOLITION APPLICATION
PLEASE PRINT 426 W. Cedar/P.O. Box 186, Shelton, WA 98584
427-9670
#1 Owner
Bob Harris DBA Bob's General Store
Phone# 275-4501
Site Address 22551 Highway 3
Mail Address Same City Belfair
City Belfair
Applicant O'Sullivan Petroleum St WA Zip- 28
N1Pment n Phone# 682-2440
Applicant Address 3214 - 16th Ave S.W.
City Seattle
I St WA Zip 98134
#2 Parcel No. 12332-50-00103_
Legal Description Sam B. Thelers
HO�n Garden Track, Track #43
#3 How will the debris be disposed of? Debris will
Mason County Garbage Service.
_1
#4 Use of building to be demolished? N/A
#5 Indicate by circling the applicable source if any water is on or ad'
saltwater marsh lake river adjacent to the property:
po wetland seasonal runoff other 3'
Directions to Site: Head North on hi
9hWay 3 the site will be on the left
before ou enter Belfair.
�6 Project Start Datex 7-6-93
Project Completion Date*7-13-93
'Upon completion of demolition, owner must call for final inspection.
'Plot plan on back side of this paper must be completed.
DEMOLITION PERMIT FEES: $25.00 VOLUNTARY DEMOLITION
$40.'Make checks/money orders payable to Mason County Treasurer and 00 Ambit Ao EMENT ORDER
Mason County Building Department for processing,
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Show following on the site plan
Lot Dimensions Flood Zones S
Existing Structures Fences
Structure Setbacks Wells
Water Lines Shorelines
Drainage Plan Easements indicate directional by
Septic Systems Name of Fronting Street N, S, E, W etc.
Proposed Improvements Name of Flanking Street
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Date: 5-25-93
Applicant Signature
00t C1= 1ClAL 1J5 ONLY A►ceptd by
gate
Receipt No.
Amount Paid
.;: .
DEPARTMENTAL REVIEW
FOR OFFICIAL USE ONLY _--
Proposal Proposal
Approved Denied
r
ning:
Building:
Fire Marshal:
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