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HomeMy WebLinkAboutBRN2020-00062 - BRN Permit - 11/17/2020 4 � Mason County Mason County - Division of Community Development 615 W.Alder St. Bldg.8 Shelton,WA 98584 360-427-9670 ext 352 www.co.mason.wa.us BRN2020-00062 BURN PERMIT PROJECT DESCRIPTION: LAND CLEARING BURN ISSUED: 10/26/2020 SITE ADDRESS: 11510 E STATE ROUTE 106 UNION EXPIRES: 11/25/2020 PARCEL: 222302400000 APPLICANT: STEFANKO BRIAN E&EMILY J OWNER: STEFANKO BRIAN E&EMILY J 4775 NE LAMMS LANE 4775 NE LAMMS LANE POULSBO,WA98370 POULSBO,WA98370 360.633.9289 FEES: Paid Due Burn Permit Fee $175.00 $0.00 Totals : $175.00 $0.00 REQUIRED INSPECTIONS Burn Inspection CONDITIONS " "IF BURNING WITHOUT CALLING IN,THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE SUSPENTION OF PERMIT." " Fire must be completely extinguished within three(3)days after ignition. " A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must provide 24 hour fire watch. • Maximum pile size is twenty(20)feet in diameter, a minimum ten (10)feet firebreak must be constructed around each pile. " Valid permit MUST be onsite while burning. If permit is not on site during burning the fire will be extinguished at your cost " Provide EXCAVATOR/DOZER (with fire extinguisher)on site with qualified operator. " All materials must originate from the property on which the burning is to occur. * On Site Water is required for permits between April 15th and Oct. 15th.A pump truck or trailer with 300 gallons of water loaded and 200 ft of hose. (The pump must be capable of pumping 20 gallons per minute through a one inch (diameter)50 foot section of hose.) Printed by:Ariane Paysse on:10/26/2020 01:53 PM Page 1 of 2 p - Mason County B Mason County - Division of Community Development 615 W.Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us BURN PERMIT BRN2020-00062 * APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY. Fan required. " The fire must not create a nuisance from smoke, obscure visibility on public roads and highways, or endanger life and property. * Upon completion of above conditions, applicant must have inspection &approval before ignition. Call (360)427-9670, ext. 262 * The following materials are prohibited and must not be burned: garbage, dead animals, asphalt, petroleum products, paints, rubber products, plastics, paper, cardboard,treated wood, construction/demolition debris, metal or any substance (other than natural vegetation)that releases toxic emissions, dense smoke, or obnoxious odors when burned. * Access must be passable with 2 wheel drive vehicle. * Permit includes two(2)inspections maximum, additional inspections will require a re-inspection fee. (at current rate). * A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void. After a burn ban. has been implemented, all fires must be extinguished immediately. * After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots. * Do not burn if wind is blowing more than seven (7)miles per hour. DO NOT BURN IF WIND BLOWING FROM * Each pile must be at least one hundred (100)feet from any structure and at lease fifty(50)feet from standing timber. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisio of ny other state/local law regulating construction or the performance of construction. Issued By: --- Contractor or Authorized Agent: Daterg'd�-roXb�d mmmmj Printed by:Ariane Paysse on:10/26/2020 01:53 PM Page 2 of 2 CONCRETE KAN4JWTURE.D }••AWE c= s` tsg ss FrEk l �scs icyrio€Da-,a Erft6 ar-Dab Blg D=-_ Sy -toy Fahct Ltad 1 iz�Foctinm ti L -1L O [ D--i- B moat itixaLs Fh=ls Dole Dds• BY D DECKS FRAMNG TWIS Data 'BY Date DY t BY PR€RAKE TANKS PLUMBING Dal* DRYWALL- 8y _ Dais W,pm m Line. Fire ser o© �y FIKAL IN EG tlON r �. By Hate ///7_ d2a By /7r m s Pass w Rewest SN D D n D o• I I � I m m 3 I . I I i I , � � I v m o EXPIRATION DATE: Permit#: BRN 21D Z2 —bco(c 2- MASON COUNTY BURN PERMIT APPLICATION' C I V 615 W Alder St• Shelton,WA 98584 SHELTON 360.427.9670 x352 •BELFAIR 360.275.4467 x352 •ELMA 360.482.5269 x352 APPLICANT/OWNER INFO TIQQN• CONTRACTOR INFQRMATION: Owner �:o ea�wlw — Owner Mai A dress 14�45 F—�.cw.vwr Mailing Address City OWL t�c State_ R Zip_ City State Zip Phone Cell Phone ,3hL-1. Phone Other Phone Lien/Tide Holder /V A- Contractor Reg.# Exp. E-mail address .. �. E-mail address Drivers Lic.# i a F A'Bli Mg - D.O.B.r J�^ b Drivers Lic.# D.O.B. TAX PARCEL NUMBER _ -3� ,Yzu')a (12 digit number) Fire District SITE ADDRESS(please include street name,number&city) Directions(to the BURNING IS AUTHORIZED SUBJECT TO THE FOLLOWING CONDITIONS: • Valid permit MUST be onsite while burning If permit is not on site during burning the fire will be extinguished at your cost. • The following materials are prohibited and must not be burned: garbage, dead animals, asphalt,petroleum products,paints,rubber products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural vegetation)that releases toxic emissions,dense smoke,or obnoxious odors when burned. • All materials must originate from the property on which the burning is to occur. • The fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and property. .T • Maximum pile size is twenty(20)feet in diameter,a minimum ten(10)feet firebreak must be constructed around each pile. • Each pile must be at least one hundred(100)feet from any structure and at lease fifty(50)feet from standing timber. • Do not burn if wind is blowing more than seven(7)miles per hour.DO NOT BURN IF WIND BLOWING FROM • A responsible adult and equipment shall be on site and in attendance at the fire while burning.Must provide 24 hour fire watch. • On Site Water is required for permits between April 151 and Oct. 15'.A pump truck or trailer with 300 gallons of water loaded and 200 ft of hose.(The pump must be capable of pumping 20 gallons per minute through a one inch(diameter)50 foot section of hose.) • Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator. • Fire must be completely extinguished within three(3)days after ignition. • Fan required. • Upon completion of above conditions,applicant must have inspection&approval before ignition.Call (360)427-9670,ext.262 • APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY. • APPLICANTS MUST C_ ALL 360.539.7610 ORCCA EACH DAY TO REPORT/RE UEST ANY AIR OUALITY ISSUES ASSOCIATED WITH BURNING. ************IF BURNING WITHOUT CALLING IN THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE SUSPENTION OF PERMIT.*************** • After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots. • It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished. The permitted individual is responsible for any rekindling on the fire/burn site. • A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a burn ban has been implemented,all fires must be extinguished immediately. • Permit includes two(2)inspections maximum,additional inspections will require a re-inspection fee. (at current rate) • Access must be passable with 2 wheel drive vehicle Date Received.• Application continued, please go to next page Rev.Aor 19.2017 Burn Permit# PARCEL AND SITE INFORMATION: Parcel within 200'of. Saltwater❑ Lake❑ River/Creek/Strean�Z Pond❑ Wetlands❑ Seasonal Runoff❑ : es None Slopes or Bluffs> 15%CXe No Will timber be cut and sold in parcel preparation?Yes No Does Site require FPA or 6 yr.Moratorium: Ye /No Is site being converted or replanted:Yes/ Is site located in an Urban Growth Area(UGA)?:Yes/ o/Unknown [Burning is currently NOT allowed inside UGAJ Zoning: Summarize proposed land clearing items to be burned: SITE PLAN (to be verified and approved by Planner) In the space provided below,please draw a top-view site plan of the parcel and notate locations of the following items with distances to/from"Burn Pile": o Burn Pile and Feeder Piles o Any existing buildings/structures(iei esidence, Garage, Storage shed,Driveway, etc.) o Existing standing timber o Any"Critical Areas" such as Steep Slopes, Lake,River/Creek, Wetlands, Seasonal Runoff, Streams, etc --- ------- -- --- -- ---- -- -- - - - . Q' Q� ��r c OWNER/CONTRACTOR:Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.The owner represents that the information provided is accurate and grants employees of MasmremmIX&local fire authorities access to the above described property and structure for review and inspection.The pe on in charge of N fire will be liable for the cost of suppression if the fire gets out of control or if becomes necessary to e i fire as the r suit of an enforcement action. 013 (XU SIGNATURE- BE SIGNED BY PROPERTY OWNER Date Signed FOR OFFICIAL USE ONLY: PLANNING DEPT REVIEW: Approved by&date: Denied by&date: 'I { I Al -- CLEARING I i! DRIVE ` I EXT SHED POSSIBLE WELL LOCATION GRAVITY DRAINFIELD ` 1 SEASONALSTREAM SEPTIC TANK - ------ ` _ - '� o o 1 N l BUILDING SITE O N <V N 22230-24-00000 SITE PLAN: FOR: STEFANKO JOB#: PARCEL #: DATE: 10 AUGUST 2020 BY: TJS DESIGN PAGE OF NORTH ARROW: SCALE: 1"= 300' U of 7600• p B_LINE CONSTRUCTION INC. f 1 0�� .._2-1 I -Al 50c � � S S a u