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Fail Date Date Done By Comments In 0 84cfrfi w -ri .4 /G d N O O. O N O_ N 3 .D m m 0 � �1 r �oE does chi S PLANNING: z � ; 400 7o t►ne�r v l i t o DR LL SETBACKS ARE MEASURED , �;•� `t g�tf��� 19ts'a FROM THE FURTHEST , = ' P QJ 0 0-FTHE BUILDING '� X � SITE A-7 . C a - � i`4 � ge1�c.;rJ EnI� , c, ' IAID 1 =�b 3 e I�f !�� ' RR 3 09-7 5c0-334 D FEB 2 3 2016 i M �LA,J 615 W. Alder Street r PRO D I SITE PLAN REQ ED TO BE ON SITE 48` �� CHANG S TO APPROVAL. . � $ Dade �� zGt( I Y ; G: L SETBACK RE MEASURED V �a PRO FROM ON 0 FURTHEST THE BUILDING f AP ROVED MASON ! NTY DCD PLANNING j ' �cS SITE PLA EQUIRED TO BE ON SITE CHAN S SUBJECT TO APPROVAL Date--- - —. . RECEIVED JUL 13 2011 426 W. CEDAR ST, Name Parcel# �� 1 —�5—03W BLD# I�/o1 b4 Mason CountyFEB 2 3 2016 Department of Community Development Small Parcel Stormwater Management Application/Worksheet�OSO AW-24Str,;,t Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development, or redevelopment',with more than 2,000 square feet of impervious surface'. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area "All dimensions in feet Buildings X = X = Measurements for buildings are taken at the perimeter of the farthest projections(example: = eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = X = Any paved, gravel or packed area per definition above table X = Others X = X If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area(sum of all areas) D� If the Total Impervious Surface Area is LESS THAN 2000 Snuare Feet, please read,acknowledge and sign below. Based Upo e mformatio�you rovided a Stormwater Site Plan IS NOT required for this development activity. Owner uilder/Agent Acknowled s that submissio f inaccurate information may result in a stop work order or permit revocation. edgement of such is by signature below.I de t I am the owner,owner's legal representative,or the contractor.I rth cknowledge that the information provided is accurate a employees of Mason County are granted access to the above- described property for review and inspection as may be required. X AL g tlContractor(circle one)Date: -a 3 — 1 L2 If the Total Impervious Surface Area is GREATER HAN 2000 Square Feet,please read,acknowledge and sign hhee information provided on page 2 of 2. Page 1 of 2 Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14, Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website: htti)//www.co.mason.wa—us/code/commissioners/*Mdex.ht3n Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan". This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Slormwaler Sile Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT. 450 Mail: P 0 Box 1850, Shelton WA 98584 Physical: 415 N 6th St, Shelton WA 98584 If this development has, or will have,a septic/d rain field system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other, parcel.You may also wish to consult with the septic design professional involved with the project. Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT. 352 Mail: P 0 Box 1666, Shelton WA 98584 Physical: 426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner, owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent'Contractor(circle one)Date: Page 2 of 2 2/21/2016 1400-1778 NE Blacksmith Dr-Google Maps Go- .gle Maps 1400-1778 NE Blacksmith Dr Feb, 21 2016 property photo IL - Aw) ' . r w+ �e kj `fit t v�4. AC wr A.J*V� At Ar ^Alf lot At Imagery 02016 Google,Map data @2016 Google 50 ft RrCEIVcD PLANNING FEB 2 3 2016 615 W. Alder Street https://www.google.com/maps/place/l400-1778+NE+Blacksmith+Dr,+Belftr,+WA+98528✓@47.4964058;122.9273975,197m/data=!3ml!le3!4m2!3ml!lsOx54... 1/1 r r 94O7,* ep d nS leoiboloao-S (1'BGololpjibiq 9 LOZQ,� ha&ull- 416009 91OZ(�) 3160OLD L it A+ Z p T ' I a .1M aF _• a�e�dn Jo ;na wt,nz asnajd . slInsai ON r� +�BpN COUH�r MASON COUNTY COMMUNITY SERVICES Permit No: / PERMIT ASSISTANCE CENTER: Recv'd: BUILDING•PLANNING•FIRE MARSHAL 615 W.Alder St-Shelton,WA 98584 FEB 2 2016 - Phone:360-427-9670 ext.352 Fax:360-427-7798 u http://www.co.mason.wa.us/community dev/ 615 W.Alder Street BUILDING PERMIT APPLICATION AIIAn PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: I o i,-i)�, <,�- NAME: MAILING ADDRESS: ,p, ?),,x I 2-7 MAILING ADDRESS: CITY:?jz 1,Cr„t ( STATE:\0.1 _ZIP: CITY: STATE: ZIP: PHONE#1:_3(e0--3-7 L- 224 5- PHONE: CELL: PHONE#2:-z,�o--c)Gy- D`7SD EMAIL: EMAIL:,$- 1-lotscbe Cc tl.-'l.00, 'arn L&I REG# EXP. CONTACT 'PERSON: OWNEAa CONTRACTOR❑ OTHER/BELOW❑ NAME: O e,5"e- MAILING ADDRESS:P.O, '�,-%X 19 Z7 CITY: STATIE: WA ZIP: � Z PHONE:3(�-�i7Z22tl�CELL:Jyo ilgo-g753 EMAILQ— as e 5 VA F+oo• eb•n PARCEL INFORMATION: G PARCEL NUMBER(12 DIGIT NUMBER) Z 2.3 0 r1 -7$-oc 33C,> ZONING LEGAL DESCRIPTION(ABBREVIATED)BIZ 3S Of S 0r t/e-k "tJ/7 FIRE DISTRICT STIE ADDRESS 7 0,L/0 CITY i tcK- t r DIRECTIONS TO SITE ADDRESS IS PROPERTY WITHIN 200 FT: (Checkan that apptv): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14% YES[] NOO[v TYPE OF WORK: NEW,,(] ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) ,r a S 1P'0 IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDR OMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Part[s]of Bldg)❑ NNOS DESCRIBEWORK ?o)'L, bJ:1cftnrt SQUARE FOOTAGE: I ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DEC sq. COVERED DECK sq STORAGE sq.ft. OTHER sq.ft. G E!a 3 o ❑s ft. ATTACHED -DETACHEI)�*N CARPORT sq.ft. ATTACHED❑ DETACHED❑ F CTURED HOME INFORMAT *4 COPIES OF THE FL PL RE UIRED MO YEAR LENGTH BEDROOMS BATHS SE NUMBER OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner or owner's legal representative.I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permittappl!cation becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended fora period of 3 PROOF F CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIR180 days. E ■� � APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) FEB 2 3 2016 x _ 2.• 23- Ito Sigrfature of OWNER Date 615 W.Allier Street DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT x 4 ? PLANNING DEPARTMENT FIRE MARSHAL PERMIT SPECIALISTS Intake By: Approved&Ready for Pick-Up: