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Home My WebLink AboutPAR2015-00037 - PAR Application - 11/16/2015 RECEIVED NOV 16 2015 MASON COUNTY PUBLIC HEALTH F UAL USE ONLY COMMUNITY DEVELOPMENT o" ' ENVIRONMENTAL HEALTH REVIEW ate_ 415 N.6th Street PO am11666 Shdton,WA9BSM (3-W 427-9670,rxt 400 W)2754467,ER.400 n - 3 I.Appu«ntlPmparty Information "°�`"`Pei?ir7sd/a Asp/'/ CCG ��K � �e��avr KyA 9BSZ8 e-5 ; '7d of N� T/ry�f�rf ae Or off 2.Typeoi Renew/Job 3.Job/Site Information aenaru�wN ❑ Residential ❑Commercial [I Tennant Review ❑ New ❑ Replacement APre-Applkation + _ ❑ Remodel ❑Addition ❑Other(explain below) "„a"„e°" ftpm i1 Tod°e°°01A5 0eaee"�Lo e Co 7P SubeI- .v isipn nsbnanoae aaarbroa rtp4o mop + - nmonssart nopevd54ft Tn soft - ra®nmtt6varro) raW NUMe,arrkus aaarlmemaditneedmmig an Fxidkg Rom Ppn and Proposed Rom Plan wllh towndkatlonc afar Papas2elixl]. gopegmmueaie6enm7 4.On-She Sewage System/Sewer Infmm tritm Glopery5evea ily. farF.eauRaiaavposee tsand �On-Site Septic System JgNew El E)dsting �"'"°'arnpyKso�vq�ea ❑Sewer ❑ New ❑ Existing 5.Water Source Mformation ` OrxP°"'u`1 Plumbing in structure? ❑Yes ❑No wmeasawer symaraooaoee) If yes. Wing wexism9on-slo septicsystmVAreegdreaoxreatmalnrenancerepmt Pkmsesubmha completed WaterAdegttauyForm. aMaxemdorawingtAmoatl.ixam fortmnoftte mgniremennmay An Incomplete submitted Water Adequacy Form may be been,file wthUs Gm,tyPotscNealth.oaerreydr ntsnoyapdy. returned,and hold up review process. She Plan A scaled She Plan is required with all permits,except interior remodels.An Incomplete submitted site plan may be retamed,and hddupreviewprocess. Papersbeforsitep6nranbeaSxll,&5x74,a11X17lma4.Pleaseusedteddbtbebw: ❑Property linesftimensions ❑Primary Drainfield area []Reserve Drainfietd area ❑Edsthlg/proposed wells ❑Waterlines ❑SepticTanks location ❑Incationofcurtaintperimeterdmins ❑Direction of Slope ❑Driveways/Parkingareas/Easements 05cistingstructures/bundings ❑Proposea5tnrctures/Bulldings ❑Seweritnesnanks ❑Addltions ❑Norrh Arrow ❑Scale Bar Applicant Signature'Si �e— Date /_o 1a/x1 S Official me only � Departmental Review Approval Inds. Date Notes,Conditions,Related Permits Water Adequacy An A Sewer/Septic System Tenant Review Revision THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLICVIEW ON THE MASON COUNTY WEBSrfE Revited2fW015 RECEIVED - � �'I�`� NOV 16 2015 426 W. CEDAR ST. PAR_,)�01�j- (�X) 17 DATE PRE-APPLICATION CONFERENCE REQUEST FORM The purpose of the pre,-submission conference is to identify andfor eliminate as many potential problems as possible in order for the project to be processed without delay. Representatives for the Fire Marshal's Office,Building Department, Environmental Health, Planning, and Public Works Departments may attend the meeting to discuss rules and regulations applicable to the proposed project. Topics covered during the meeting will include the comprehensive plan, shoreline program, zoning, availability of sewer and potable water, development concepts, building construction, fire protection and life safety concerns of the proposed project. The pre-submission conference will be most informative when you provide accurate and detailed information on the Pre-Application Conference Application Form and the site plan.Applications will be accepted when all information is received and deemed complete. Pre-Application Conferences are held every Wednesday and last up to one hour. To schedule a meeting complete the applications and return with 6 copies of the detailed site plan, by 3:00 PM on the Wednesday two weeks prior to the Proposed meeting. 1.Pre-Application/Dept.of Community Dev. 2.Environmental Health 426 W Cedar Street 415 N 5' 1 PO Box 1666 Shelton,WA 98584 Shelton,WA 98594 360.427.9670 ext-352 360.427.9670 exL 400 Check amount: $255.00 Check amount:$205.00 BOTH CHECKS MADE PAYABLE:MASON COUNTY TREASURER Applicant: site Plan leP_Vow Submit 6 copies Mailing Address:/'&1&/ /7S� API*h- PV4 R>'Z(f Include thef0flowmg information Daytime Telephone:X0 275 67?-4- —Fax: 0 Indicate Scale and NortbArrow Email address: V(f P JITIA1 C. 17e 7' U Property line diniansions,easements, Representative' andrigbit-of-ways. Name:J_/eVPi WZ:T 1'0_rtll/�7171 and 0 The location of all einstaig proposed structim.Include square MailiugAddress: 40 90A �9,�?6 S-/lVeea��e AW 9M,? footage of existing and proposed structures. Daytime Telephone:,:90 6 92 00 Fax: Email address: Ce_,Te 6ait7b,-,d�pe. tie+ 13 Setback distance,in fed from an property lines and structures. Parcel Number. (12 digits)/03 26 - 3 2 - 6000 6 11 E)dsting and proposed road access to Description of Project: and from the site. Include: 1)Square footage of structure,2)Use of building and rooms(i.e., C1 Parking sites Office,warehouse,restaurant,storage,etc),3)Occupancy classification per 13 Location of on-she sewage tanks and IBC, Section 302.1,and construction type.4)Provide two sets of plans,if drainfields. 0 Location of drinking water supply. available.Use separate sheet if necessary Include location on the proposed she �LC e Zd Jej6alIV15-let2 o f b 6 7 and surrounding parcels. U Steep bluffs,wetlands,streams,and bodies of water 0 Location of fire hydrants and emergency vehicle access roads, including grade. Ll Surface and storm water run-off routes. 4clo l - Has the project been discussed during a previous Pre-Application Conference: If yes,please indicate date. A/O Will the building have employees?If yes,how many? /LSO What is the water availability of the proposed project?If there is an existing well,what is the name of the system? What is planned for the on-site sewage system?If you are proposing a new on-site system provide detail on the required site plan. -tom%yl&� la/ 41-7 .51le SP��ic sys�`�rr/r C &�7Cfi /6 f rn ADDITIONAL INFORMATION.• ka evi lo O 2 O L 1 N(cn La.t f A./ ' i i APPLICABLE BUILDING CODES 2012 International Building Code/2009 International Residential Code 2012 International Fire Code-ANSI Al 17 2012 International Mechanical Code—WAC 51-42 2012 Uniform Plumbing Code—WAC 5I-56151-47 2012 International Energy Cons.Code/Washington State Energy Code—WAC 51-11 C&51-11R Mason County Ordinance Title 14 Code changes are on a 3 year cycle,effective in July of that particular year. Date of Conference: L 2 s Time of Conference: ', 6 Location of Conference:426 Wert Cedar Street,Shdton Planner: 5 ext. CJ' 1 a c rn .�'' •�• N ° U .- ,ply ° u•uy„ \ c'- m � c c o a p -3.. 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