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HomeMy WebLinkAboutSPI N/A - SPI Application - 5/12/2000 MASON COUNTY SHORELINE PRE-INSPECTION APPLICATION$70.00 Fee Re wired pLEASE PRINT nn Applicant: 1. owner: ............... �41,14 Applicant Address: Zi 3 Site Address: city: _7' Owner Address: Phone: 01, q0 17e City: ,i-verepAtfi-Sty—A ip parcel N .. .................. C7� 'ef 2. q Phone: A-43pFf-V411-1 5up, V Leg I Description: ) 5 tion: -_(V Ew ................... '7-/ 3. Purpose Pre-Inspection: AJ A 4Pre LiD 4. Use of Building: saltwater lake of water on or adjacent to property? ff other 5. is there any type wetland ---. seasonal river ______ pond --- stream --- seasonal creek D fa 6--A L 111 If A-) Directions to 'Site: iq c:- L_PIK C_ 0 Aj CA 14/ Al suiting from then mason County must disclaim.any errors re If the information is incomplete, ti -inspection reports remain valid only until the original application.. Pre lot evaluated in this inspection. deficiencies in ur irvffio vicinity which affect the development changes occ AeA_0� Date: 1"iL 01 r," "FM1_ Applicant Signature: f Community Development,Plannllnm� Return appQ�a� lication to: Department 0 p.O. Box 578 MAI Shelton, WA 98584 (360) 427-9670 OURWw"'011-CENTER money order payable to Mason C Please include a $70.00 check or m Date: FOR OFFICE USE ONLY: Accepted by: Please illustrate below the proposed buildingsite i n relation to water & property lines; t) on Departmental Review (For Office Use Only) Planning Department Findin s: �' -C �