HomeMy WebLinkAboutBLD12691 Bulkhead - BLD Permit / Conditions - 7/8/1982 IF
Calhoun Wayne #12691
249-4�72, Montesano 7/8/82
Portion of Lot 3 (Govt._Lot) , 25-21-2
1/2 mile south of point/turn left after crossing brig,^19
4 miles/right side of road.
Bulkhead (Erosion Control) Contractor:
Self
$2,800.00 Shoreline Exemption
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BUILDING PERMIT'APPLICATION
!` MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 4 (y
2 6-5593 O `
- DATE ISSUED
` ,.. PERMIT NO.
NAME ;:* MAIL ADDRESS ' CITY6 STAT ZIP PHONE '
OWNER 'cob . t , 4. b
DIRECTIONS- /' r
TO`JOB SITE /L MILS
LEGAL •�' "` Jf 0I� EA ACMEDi HEET)
DESCR
CONTRACTOR NAME ..," MAILADDRESS CITY'&STATE - LICENSE NO. " PHONE'.
d
USE OF
BUILDING
Class of work: ❑`NEW `D ADDITION'- ❑ ALTERATIONS.- ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe,work:
AL
Valuation of work: $ O O�. PLAN CHECK FEE PERMIT,FE;�.-
SPECIAL CONDITIONS:..
BEDROOMS DECKS *. CARPORT D; `. NOTICE -
BATHROOMS ITOTAL SO.!FT. GARAGE Ell: -
ATTACHED 1i SEPARATE PERMITS.ARE REQUIRED. FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES_ BASEMENT O OR AIR CONDITIONING - -
TOTAL SO. FT" 'FIREPLACE ❑ - DETACHED 0 •' - T
CONTRACTOR WORK NNO COMMENCED T BECOMES
WITHIN
VOIDIFWORK OF CONSTRUCTION AUTHOR
-
CONTRACTOR AFFIDAVIT �- - - IZED IS NOT COMMENCED WITHIN 100 DAYS,OR IFC NSTRUCTION OR WORKIS'-
ABANDONED FORA PERIOD OF 180 DAYS AT ANYTIME AFTER
certifythat I am a current) registered contractor.in ;^
currently
'registered
State of .Washington and I am aware of the -
ordinance requirements regulating the work for which FOR OFFICE' LIS "'ONLY
the permit Is issued and all work done will be in '
conformance therewith. PERMANENT ❑ SHORELINES
SEASONAL'0. FLOODPLAIN ❑
Firm .. _ E.D. NO. SE.P,.A ❑ 'I
By Special APpr6als' IN -OUT I YES APPROVED NO
Lic.-No. ' Date ^ .ZONING
- PLANNING,DEPT.
OWNERS AFFIDAVIT HEA
. , PUBLIC WORKS ., ._
I certify that I am exempt from the requirements of the FIRE MAR HAL I '
contract or registration law--.RCW 18.27, and am aware UILDIN_a a B
of the Mason County ordinance ,requlrements for '
which this,permit is issued and that•all work done will ROAD ACCESS `
be formance therewith. - MOTOR VEHICLE PERMIT
PLICATION CC PTEd'BY PLANS CHECK BY APPROVED FOR ISSUANCE-
Owner Date " BY
>
PL - V CHECK VALIDATION CK. Y.O .CA'SH U PERMIT VALIDATIONy CK; M.O. CASH, .�
PLOT PLAN
ADDNESS w,. PERMITNO. 4 ^v
LEGAL - e.
DESCRIPTION LOT BLK` ADDITION `
SITE AREA Sq. Ft. ' AREA OF,SITE OCCUPIED BY BU,ILOINGS _Sq. Ft. '
INSTRUCTIONS TO APPLICANT
" .THIS FORM-NEED'NOT-BE USED.:WHEN PLOTPLANS DRAWN TO",SCALE OF NOT LESS THAN 1"-20' ARE
FILED'WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE.A"SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN:=THE SPACE BELOW:. LOCATION OF
PROPOSED CONSTRUCTION AND.EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS.SHOW EASEMENTS, FINISH:CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET EL€VA- ,
TION AA'D'SEWER SERVICE ELEVATION. SHOW L
TION THEREOF. OCATION OF WATER, SEWER, GAS AND',ELECTRIICAL
SERVICE LINES.SHOW LOCATION OF SURVEY_FIN
S..SPECIFV THE USE OF EACH°BUILDING AND MAJOR OR- .
•, -
OINDICATE NORTH IN GRAPH SQUARES ARE 5' X ' OR 1"=2099 TN
I/We'cenifythat the proposed construction Will conform to the dimensions,and uses shown'above and that no Chang a will be made without =
first obtaining approval: -
NA E/el UF QWNERINI OF SITE • lTRUSTUREIl1 (PRINT) _ '= 13aNA V F OWNE ( OR AU THOR12E0 REF' El EN TA TIVE
DO,NOY.WRITE"BELOW-TN/SL/NE
A APPROVED
DISTRICT - AS NOTED ' # DATE,. -
{HCLTON PRINTING _
r;
- EXEMPTION FROM SHORELINE
MANAGEMENT ACT SUBSTANTIAL
DEVELOPMENT PERMIT REOUIREMENT
TO:
The proposal by Way ne Calhoun. to undertake
name o app scant
the following development Erosion Control Bulkhead
e sped is
upon the following property A portion of Government Lot #3, Section 25,
(legal description; i.e. , section to the
Township 21 N, Range 2 W, ,WM
nearest quarter section
within Case Inlet and/or its associated
name of water .area
wetlands is exempt/not exempt from the requirement of a 'substantial
development permit because the-development'
173-14=040; (3) :
i enti y `exemptions as outlined in ,WAC -1 -0 0 ..
s C
Corps Pub.lic tNota. e Number ii Ej avaa I a e'
The proposed development is consistent/inconsistent with. '
r
CHECK ONE
CONSISTENT INCONSISTENT -
X Policies of the Shoreline Management
Act. {
The master program. ft
8 July 1982
Date
(Signature of Authorized Local Govern
ment Official)
8 July 1983
Date )f Expiration