HomeMy WebLinkAboutRLC94-01384 for BLD94-1169 - RLC Application MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
RESOURCE ILANDS AND CRITICAL AREAS CHECKLIST
Permit Number kL1>Ok j "w ! RLC# r0624
Owner \I y1/1A 1
Parcel Number
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❑ 1. Saltwater shoreline or lake 20 acres or larger?
\ Name of Water Body
❑ 2. Rivers, streams. or creeks with year round flow? .
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Type of Other Water
❑ 3. Rivers, steams or creek with intermittent flow but are within a clearly defined channel?
❑ 4. Lakes or ponds less than 20 acres in size? (�
❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal
circumstances sypp�rt vegetation adapted for life in such conditions; such as marshes, bogs,
and swamps.
❑ 6- Slopes greater than 15% (8.5 degrees)? On Landslide Hazard Map?
�El7. Floodplains? % of Slopes
❑ 8. Seismic Hazard Areas.
❑ 9. Agricultural Open Space Taxation Program?
❑ 10. Open Space Timber Taxation Program, or Designated forest or Classified Forest?
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11. Site has no Resource Lands or Critical Areas. (�i� � I�f�i a►'C�f
Comments:
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Authorized Signature Date