HomeMy WebLinkAboutSPH93-0161 - SPL Application - 9/30/1993 MASON CON LATH SERVICES
SFP 3 Q 1993 POST OFFICE BOX 1666
SHELTON, WA 98584
,` L SERVICES
/sue (206) 427-9670
i�ICt�0 1 SERVICES` FAX 427-8425
APPLICATION FOR SHORT PLAT EVALUATION
Receipt No: /
INSTRUCTIONS - Date of Payment:
1. An application in considered complete when the fee is paid and the following elements have been addressed:
• Parts 1 and 2 of the application form moat be completed.
• one properly excavated backhoe pit per proposed parcel must be ready for inspection. Properly excavated pits
are 6 ft deep with a a ft deep shelf on one end of the pit. The a ft deep shelf must slope up to the ground
surface for easy ingress and egress.
• A scaled plot plan moat be attached to the application. The scaled plot plan must show the precise location
of the teat holes, dimensions of the Property, and location of any existing or proposed wells, roads, or
buildings within 100 ft of the property boundaries.
2. After a completed application is received, staff will inspect the property and provide the applicant with a
written report. If the project requires more assistance than the evaluation of four test holes and completion
of this report, an hourly rate of i37/hour as set forth by the Mason County Board of Bealth may be charged to
the applicant. Bevisad 0099/01/92
PART 1: APPLICANT/PARCEL IDENTIFICATIONa� ••••,,,......
• NAME OF APPLICANT C'INPY SUMD / M,4RGAt?E-F NIFLSBN• TELEPHONE (ZOG ) 677-94-74
• MAILING ADDRESS N 2'7001 HWY 101 — REST-A- WLE K.\/. PA2IL
1-i yspOQT 1nlP �l8548
` CicY lc�c� m1P
• ASSESSOR'S PARCEL NUMBER 3 Z 3 3 ( - 2 3 - 0 0 0 2 O 1
• LEGAL PROPERTY DESCRIPTION POr lnhl O F7 COV L�' LOTS `L� 3 SEC. 3(
T. 23 ". 2.3 W. W.M,� G�o�3 q.
• LOT SIZES (ACRES OR SQ FT) O/ZR ?AC. 5.81 O• Ac. 0.13 AC-
rlwal r.`m 3 r.oc 3 LOc 4
• DIRECTIONS FOR LOCATING SITE Qk.ST/A-WNIL CZV JPARK - 3 MIL.E5 -
Mo2TH CIF l-{OOD- GPoem
PART 2: INTENDED USE OF PARCEL
• INTENDED USE OF PROPERTY (Check One) :
® Single family residence 0 Multi-family residence
® Other, specify: K V PARK t LOT 2
• WATER SOURCE FOR PARCELS (Check One) . ��� C
Individual wells ® Community w711
Short Plat Evaluation
PART 3.- HEALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY)
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SOIL LOGS AND SITE CHARACTERISTICS
LOT I LOT I LOT A LOT I
Test Pit A Test Pit A Test Pit A Test Pit A
r/W, _)2)1,d Q
(4,55 Ket 0�7 all i_Z3�c f
'S grL70 tV0Zc 11c, -,A
rlDep�h of root pen.: Depth of root pen.: Depth of root pen.: Depth of root pen.:
Depth of mottling: Depth of mottling: Depth of mottling: Depth of mottling: jhr1__
Depth to rest. layer: Depth to rest. layer: Depth to rest. layer: Depth to rest. layer:
21
Soil type (USDA): Soil type oil type (USDA); Soil type (USDA): nt,
Test Pit B Test Pit B Test Pit B Tent Pit B
1; 1
V
en-_Q)7d d
A Ow,
o C
71 X.
�6A
ggn 17P)
A
frLVy
I
<1 it
Depth of root pan.: Depth of root pen.: Depth of root pen.: Depth of root pen.:
Depth of mottling: Depth of mottling: 77�= Depth of mottling: Depth of mottling:
Depth to rest. layer: Depth to rest. layer: Depth to rest. layer Depth to rest. layer
,Jh4 )Mg
Soil type (USDA): Soil type USDA): E< F_ Soil type (USDA): So
Depth of root n,'Depth 0' mottling:
t.1
h to r- lay
Soil
(US"
type
Curtain drainneedeL Curtain drain needed? Curtain drain needed? Curtain drain needed?
Slope (%); Slope
Slope (%): Slope Shoreline? (Y/N): Shoreline? (YIN); Shoreline? (YIN): Shoreline? (Y/N):
1. 1 1 Z
us t 1 114
Curtain
Minim. lot size:- roe Minimum lot size:' Minimum lot size:^ VLAO�
Minimum lot 0L
Kinimuz, lot size applies to new subdivisions and is defined as the minimum allowable land area per residence or residen-
tial equivalent (450 gallons per day).
COMMENTS
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,9"P& t 110,qkye; pro77,prj err
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