HomeMy WebLinkAboutBLD2020-00592 Final SFR ADV2020-00090 - BLD Permit / Conditions - 7/7/2020 Mason County
Mason County - Division of Community Development
l kiln'.
615 W.Alder St. Bldg. 8
Shelton,WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
F
0-00592 NEW SINGLE FAMILY RESIDENCE
ESCRIPTION: NEW SFR(HILINE HOME) ISSUED: 07/07/2020
ESS: 280 E LAVENDER LN SHELTON
EXPIRES: 01/03/2021
PARCEL: 321367590103
APPLICANT: PEARSON SETH JAMES OWNER: PEARSON SETH JAMES
4231 W SHELTON MATLOCK RD 4231 W SHELTON MATLOCK RD
SHELTON,WA 98584 SHELTON,WA 98584
1.360.2291299
GENERAL CONTRACTOR'S LICENSE: HILINE HOMES License: HILINH*9836D
Expires: 11/08/2021
360-300-6100
VALUATIONS: FEES: Paid Due
R-3 VB Residential, one- 897.00 $108,752.28 Plumbing Fees $86.00
and two-family Building Permit Fee $1,160.88
U VB Utility, miscellaneous 65.00 $3,139.50 Mechanical Fees $63.00
Technology Surcharge $42.39
State Fee-Residential $6.50
Building Plan Review/Change of $110.00 $0.00
Use-Onsite Sewage
Plumbing Base Fee $25.00
Mechanical Base Fee $30.00
Planning Review Fee $240.00 $0.00
Plan Check Fee $750.57 $4.00
Total: $111,891.78 Totals : $1,100.57 $1,417.77
FIXTURES
(sty Mechanical Fixtures ( t Plumbing Fixtures
1.0000 Dryer Vent(s) 1.0000 Number of Bath Tubs
1.0000 Kitchen Exhaust Hood(s) 1.0000 Bathroom Sink
1.0000 Ductless Heat Pump 1.0000 Number of Clothes Washers
Printed by:Genie Mcfarland on:07/07/2020 08:32 AM Page 1 of 7
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
NEW SINGLE FAMILY RESIDENCE BLD2020-00592
( t Mechanical Fixtures (fit Plumbing Fixtures
2.0000 Spot Vent Fan(s) 1.0000 Number of Dishwashers
1.0000 Number of Kitchen Sinks
1.0000 Number of Showers
1.0000 Number of Toilets
1.0000 Number of Water Heaters and or Vent
2.0000 Number of Hose Bibs
REQUIRED INSPECTIONS
Setback Inspection Framing Inspection
Footing Inspection Rough- Plumbing Inspection
Foundation Wall-Pre-Pour Inspection Mechanical Inspection
Underfloor Inspection Insulation Inspection
Shearwall Inspection BLD-Final Inspection
CONDITIONS
* Concrete encased grounding electrodes must be installed and used at each new building or structure that is built upon a
permanent concrete foundation. In Mason County the electrical code is regulated by Washington State Department of Labor
& Industries (L&I).
For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415-
4000.
Printed by:Genie Mcfarland on:07/07/2020 08:32 AM Page 2 of 7
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
NEW SINGLE FAMILY RESIDENCE BLD2020-00592
* Installation of heating equipment in a single-family residence shall meet the requirements of the current IECC/WSEC
R403, applicable sections of the IRC, and IMC.
Heating equipment shall be sized in accordance to ICC/WSEC, Section R403.7. Heating and design load calculations for the
purpose of sizing HVAC systems are required and shall be calculated in accordance with accepted practice, including
infiltration and ventilation. Design calculations shall be available for inspection during inspection.
Referencing IRC M1601.4, all ducts, air handlers, filter boxes, and building cavities shall be sealed. All joints of duct
systems and seams shall be made substantially air tight by means of tapes, mastics; liquid sealants, gasketing or other
approved closure systems. Closure systems used with rigid fibrous glass ducts shall comply p y with UL181A and shall be
marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape. Closure systems used
with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-
sensitive tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings
shall be mechanically fastened. Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B
and shall be marked 181 B-C.Crimp joints for round metal ducts shall have a contact lap of at least 1-1/2 inches (38 mm)
and shall be mechanically fastened by means of at least three sheet-metal screws or rivets equally spaced around the joint.
Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation
instructions.
Duct tape is NOT permitted as a sealant on any ducts.When ducts are located in unheated spaces the ducts hall be
insulated to R-8
DUCT TIGHTNESS TESTING shall be conducted by person(s)trained to perform such testing. A signed affidavit
documenting test results in accordance to IECC/WSEC Section R403.3.3 shall be provided to the Mason County Building
Department prior to the final occupancy inspection. Affidavit forms are available on at the WSU-Energy Program website
titles, "Duct Leakage Affidavit"or"Duct Leakage Testing Results (Existing Construction)." Duct tightness testing is not
required if the air handier and all ducts are located within the heated space.
* A permanent certificate, completed by the builder or registered design professional, shall be posted on a wall in the space
where the furnace is located, a utility room, or an approved location inside the building. When located on the elctrical panel,
the certificate shall not cover or obstruct the visibility of the circuit directory label, service disconnect labek, or toher reqyired
labels.The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab,
basement wall, crawlspace wall and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the
solar heat gain coefficient(SHGC)of fenestration. Where there is more than one value for each component, the certificate
shall list the value covering the largest area.The certificate shall list the type and efficiency of heating, cooling, and service
water heating equipment, duct leakage rates including test conditions as specified in WSEC Section R401.3 & R402.4.1.2,
and air leakage results if a blower door test was conducted.
Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 5 air
changes per hour when tested with a blower door in accordanve with IECC/.WSEC Section R402.4.1.2.
The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution
panel. Air leakage testing is not required for additions less than 500 square feet. Reference IECC/WSEC R402.4.1.2.
Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2015 Certificate"and are
available in '/4 or'/2 sheets. The Mason County Permit Center will also have some available.
* All surface water and potential runoff must be controlled on site and shall not adversely affect any adjacent properties nor
increase the velocity flow entering or abutting to any state or county culverting/ditching system or roadway.
Printed by:Genie Mcfarland on:07/07/2020 08:32 AM
Page 3 of 7
r 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
NEW SINGLE FAMILY RESIDENCE BLD2020-00592
All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building
Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration.
Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No
more than one extension may be granted.
* CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING
DEPARTMENT AND THE ADOPTED BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All
construction must be in conformance with the international codes as amended and adopted by Mason County. Any
corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting
additional inspections.
* All construction must meet or exceed all local and state ordinances in addition to the International Codes requirements as
adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted
classification. Any non-approved change of use or occupancy would result in permit revocation.
* All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or
any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
" A minimum of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance
with IECC/WSEC Section R404.1.
" By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your
"Approved Site Plan"to ensure these structures meet the setback conditions listed.
" All building permits shall have a final inspection performed and approved by Mason County Building Department prior to
permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property
records on file with Mason County as being non-compliant with Mason County ordinances and building regulations.
* All RED stamped approved plans are required to be on-site for inspection purposes. If an inspection is called for and
plans are not available on site, then approval will not be granted. In addition, a re-inspection fee(refer to current fee
schedule, minimum 1 hour)will be charged and must be collected by the Building Department prior to any further inspections
being performed or approvals granted.
" Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufacturer
specifications and in accordance with IRC Section R315.
Alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on each level
of the dwelling.
EXISTING DWELLINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of
fuel burning appliances), repairs, or additions requiring a permit occur, or when one or more sleeping rooms are added or
created.
* The stamped approved site plan is required to be on-site for inspection purposes. If an inspection is requested and the
approved site plan is not on site, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule,
minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being
performed or approvals granted.
1.* The plan review check list and corrections are part of the approved plans and must remain attached. It is the responsibility
of the applicant, owner or contractor to make the required corrections indicated on the plans. Once the plans are marked
"APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is
responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal of approved documents will result in failure of required building inspections.
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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
NEW SINGLE FAMILY RESIDENCE BLD2O2O-00592
* Adopted IECC/Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine-4C,Window(Max U-
Factor):0.30, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less, Wall insulation R-21, Floor insulation
R-30, Ceiling Insulation min. R-49, Vault Insulation R-38, and Slab Insulation R-10.
3d - HIGH EFFICIENCY HVAC EQUIPMENT 3d:
Ductless Split System Heat Pumps, Zonal Control: In homes where the primary space heating system is zonal electric
heating, a ductless heat pump system shall be installed
and provide heating to the largest zone of the housing unit.
5a- EFFICIENT WATER HEATING 5a:
All showerhead and kitchen sink faucets installed in the house shall be rated at 1.75 GPM or less.All other lavatory faucets
shall be rated at 1.0 GPM or less.c
* The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more
than 150'from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards
for Fire Apparatus Access Roads up to the point where such roads connect with a county maintained public road or to
another fire apparatus access road which connects to a county maintained public road.
* Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and
MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either
private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an
existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance
and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting
from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any
construction which is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that
office to review future planned work which may affect your project.
* When parcel development requires direct access to state road(s), a Road Access Permit or Approval must be granted and
approved by the Washington State Department of Transportation. For more information contact Washington State
Department of Transportation, at(206)357-2620, ext. 630.
" A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit
application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the
responsibility of the owner/agent of the developed parcel. It is the owner/agent/contractor's responsibility to ensure that
Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement
of any development activities. "NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel
Stormwater Site Plan"constitutes an approved plan based on the criteria listed on the application/worksheet. If the
development has, or will have, a septic/drainfield system you are responsible for contacting 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. By calling for a final
inspection of the building permit the owner/agent/contractor is acknowledging that all components of the stormwater
management system have been installed as approved on the stormwater site plan.
Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and
MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either
private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an
existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance
and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting
from a Mason County Road,Contact the Mason County Public Works Department prior to construction at Ext 450. For any
construction which is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that
office to review future planned work which may affect your project.
Printed)y:Genie Mcfarland on:07/07/2020 08:32 AM
Page 5 of 7
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
NEW SINGLE FAMILY RESIDENCEBLD2O2O-00592
* The foundation/footing must be placed on undisturbed,firm-native soil.
* Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the
structure.
* Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather,
garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of
3000 psi (IRC Table R402.2).
.,All property
., _ . ..
p p y li nes shall be clearly identified at the time of foundation inspection.
* The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not
allowed without the approval of the Mason County Fire Marshal
REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable
provisions of the current code and the manufacturer's installation instructions.
A drip edge shall be provided at eaves and gables of shingle roofs.
* WIND LOADS - Roof coverings shall be designed and tested to withstand the maximum basic wind speed. The basic
wind speed for Mason County is 85 MPH.
* Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site
plan. Please check your"Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed.
OWNER/BUILDER acknowledges 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, owners legal representative, or
contractor. 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 authorized agent 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 permit/application becomes null &
void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of
180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
* Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly
corrode metal fasteners, connectors, and flashing. Install metal connectors'approved for contact with the new types of
pressure treated material.
* When parcel development requires direct access to county road(s), a Road Access Permit or Approval must be granted by
the Mason County Department of Public Works. For more information contact Public Works, at(360)427-9670, ext.450 or
100 W Public Works Dr. Shelton.The building permit will not be finaled until the permit holder can show proof that the
access permit from Public Works has been finaled and approved.
* Retaining walls needed to support a surcharge such as structures, roads, or to support slopes, shall require a separate
building permit and approval prior to construction of the retaining wall.
" Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance
with Mason County Title 14.28 and 14.17.
* Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries,
Contractor Compliance Division.There are potential risks and monetary liabilities to the homeowner for using an
unregistered contractor. Further information can be obtained at 1-800-647-0982.The person signing this condition is either
the homeowner, agent for the owner or a registered contractor according to WA state law.
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Page 6 of 7
-n Mason County
- .
Mason County - Division of Community Development
�y s: 615 W.Alder St. Bldg. 8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2020-00592
* A separate inspection in addition to the inspections required in the IBC, Section 110 shall be required in accordance with
the 2015 IBC, Section 1705.12.2 and Section 1707.1. The additional inspection is required when shear wall fastener
spacing is required to be 4 inches or less. The shear wall schedule shown on sheet S2 designate FRONT WALL
ADJACENT TO ENTRY DOOR with fastener spacing 4 inches or less.
The required inspection may be performed by the Mason County Building Department, a WABO certified inspector, certified
to inspect lateral connections, the Engineer of record (EOR), or an authorized representative of the (EOR). The special
inspectors duties and responsibilities shall be as specified in Chapter 17. When a third party inspector is used to perform the
inspection, special inspection reports shall be submitted to the Mason County Building Department, 615 W Alder St, Shelton,
WA 98584 and also available on site for review by the Building Official. Inspection reports shall be completed and submitted
to the Mason County Building Department in a timely manner and shall be submitted prior to the framing inspection of said
project.
* Residential developers and individuals shall be required to control erosion during construction. Removal of vegetation
should be minimized and any areas disturbed should be restored to prevent erosion and other environmental impacts.
* Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel.
Property is Zoned Rural Residential 5.
* The stream on the Northern edge of property is regulated by the Mason County Resource Ordinance. There is a Minimum
150'vegetated buffer requirement from the edge of the stream. In addition, there is a Minimum 165' building setback for all
development from the stream.The proposed residence has been approved at 460'from the stream as indicated on the
submitted Site Plan.
* Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained
* Applicant/Owner assumes all responsibility if On-site Sewage Components are encumbered.
A.) Drainfield/ Reserve requires a 1 Oft setback from all footing/foundations.
B.)Septic tank(s) requires 5ft setback from all footing/foundations.
C.) No foundation/Perimeter Drains within 30ft, down gradient of Drainfield/Reserve area.
D.) No Cut Bank(s) (greater than 5ft and over 45 degrees)within 50ft, down gradient of Drainfield/Reserve area.
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 provisions of any other state/local law regulating construction or the performance of construction.
Issued By:
Contractor or Au o -zed Agent: Date:
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A
MASON COUNTY615 W.Alder St.Bldg 8,SHELTON,WA 98584
,COMMUNITY SERVICES SHELTON:360-427-9670,F_)CT 352
BELFAIR:360-275-4467,EXT 352
Building,Piarmin%Environmental Heaith.CommunityHealth ELMA:360-482-5269,EXT352
is www.co.mason.wa.us
INSPECTION CARD AND CERTIFICATE OF OCCUPANCY"
To schedule an Inspection call or visit http:/Mw.co.mason.wa.ustcommunity-servicestbid4nspection.php
Permit,Number BLD2020-00592 Date Issued 07/07/2020 Issued By
Project NEW SFR(HILINE HOME)
Site Address 280 E Lavender Ln
Applicant PEARSON SETH JAMES
Contractor HILINE HOMES
Contractor Phone 360-300-6100
Primary Code UPC IBC,IRC,IFC,IEC,IMC,& Type
Permit Type NEW SINGLE FAMILY RESIDENCE Occupancy
-APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS.
-DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED.
-THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION,FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY.
-ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION.
-OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION.
"THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED.**
PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET
Public Works Access/Driveway Other
Health Septic Well
Deptartment
Planning Site Inspection
Department
Fire Marshall Fire Apparatus Access Fire Sprinkler
Auto Fire Alarm Hood and Duct
Other Final
Building Building Official: Community Services Designee
Department
Concrete Setbacks Slab
Footing Peritn er p Point load Footing
Footing Interior Irmf 4 Footing Decks/Porches
Foundation Stem all Other
Rough-In Groundwork Plumbing Framing I.1rZ1bEC
Groundwork Mechanical Plumbing t2g/.Zd-L o J?L
Groundwork Gas Pipe Mechanical
Gas Piping Shear Wall Nailing
Underfloor
Other ()� .� ., �.�t'rG�"Q5 �� r Z'e
Insulation Slab Ceiling -'kc.a fVL_
Floor ,1 T"2 V C— Vaulted Ceiling
Walls f r r 2 LL Vapor Barrier •!7.Zl � y
Other
Wallboard Interior Wall Brace Panels Fire Walls
Nailing
Other
Final Building ;c-n
Manufactured Setbacks Setup
Home
Concrete Foot/Runners Final
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e artment of Community ment 1 5 VV. Alder S p y p Street
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:
httpHwww.co.mason.wa—us/code/commissioners/index.htm
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 Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A)44 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 ra infield 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 , \ /��� Ot/�4��_ wne Agent/Contractor(circle one)Date: e&J.—O-10
Page 2 of 2
r �
NameL _1 Parcel# p—"'JS—q0J 1z— BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
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 surface2.
'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.
2Common 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.
Surface Type Length X Width = Area *All dimensions in feet
Buildings X =
X = Measurements for buildings are taken at the
X _ 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)
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
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 � (caner Agent/Contractor(circle one)Date: ob_
If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign
the information provided on page 2 of 2.
Page 1 of 2
MASON COUNTY COMMUNITY SERVICES Permit No: d a
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone JUN 12 2020
Belfair.(360)275-4467•Phone Elma:(360)482-5269
BUILDING PERMIT APPLICATION 615 W. Aid eet
PROPERTY OWNER INFFORMATION: CONTRACTOR INFORMATION:
4a NAME: n �'CF'C�i�n NAME:
MAILING ADDRESS: al w. IL1NG ADDRESS: I►3pt� �wpo_E
CITY: STATE:i,. . ZIP: CITY: lJ ' STATE:t-tr. ZIP:e5Eaa!�,
PHONE#1: ' PHONE: -%i62-tom CELL:
w PHONE#2::3(yp aaA-Ia•Pk EMAIL: skAYte oil 9L• C�O 00
vwyy EMAIL:41y.1sYb C% co 1yy.Iscv� wtyC L&I REG#l'! �
.•.dP.sR;.'g
PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER
TAME - �AL�, �C�rrn EMAIL �8"Stbir 0 a`Q1n�►��`i�
MAILING ADDRESS 'A A3\ CITY STATE %-43,0— ZIP '1
PHONE CELL ZSaQ-a�1,�_��
PARCEL INFORMATION: /I �
PARCEL NUMBER(12 Digit Number)3�\2 �P oin%Q.) ZONING Q�
LEGAL DESCRIPTION(Abbreviated) V\ 3 •�0 3�n1 FIRE DISTRICT
1 t]
a s�
SITE ADDRESS CITY 5
DIRECTIONS TO SITE ADDRESS O J T- CcrY S
J l 7
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO;*
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM)q
TYPE OF WORK: NEW ADDITION❑ ALT(�ERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) r LD b�s&,g\ce
IS USE: PRIMARY gpSEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS_X—
HEATED STRUCTURE? YES(Whole Bldg)D( YES(Pari[s]ofBldg)❑ NO❑
DESCRIBE WORK 0,Ah&1-1Jdi% 01 Jr Vr 9, V00X7a ^G�
SQUARE FOOTAGE: (proposed)
1ST FLOOR_sq.ft. 2ND FLOOR„ _sq.ft. 3RD FLOOR- _sq.ft. BASEMENT sq.ft.
DECK_ sq.ft. COVERED DECK_tf5 sq.ft. STORAGE_ _sq.ft. OTHER_ _sq.ft.
GARAGE_ _sq.ft. Attached❑ Detached❑ CARPORT_ _sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: -(\IA *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES% NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 5, NO[] EXISTING SQ.FT.
EXISTING BEDROOMS _ PROPOSED BEDROOMS TOTAL BEDROOMS
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 and 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 permitlapplication becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42) C1
X Lde�-Cll EJ an I aci
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED. DATE: TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT Sn—
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY COMMUNITY SERVICES Permit No: 1BICI 262-0 -06 5q a
PERMIT
BUIL ASSISTANCE DING •PLANNING •FIRE MARSHAL RECEIVED
615 W.Alder St-Shelton, WA 98584
www.co.mason.wa.us JUN 12 2020
Phone Shelton:(360)427-9670 ext 352• Fax:(360)427-7798
Phone Be/fair: (360)275-4467• Phone Elma:(360)482-5269 615 W. Alder Street
kA .
t
" PLUMBING & MECHANICAL PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:`SP Ire e--CA(tc►/\ NAME:_�E'
MAILING ADDRESS: AILING ADDRESS:
CITY: STATE: ZIP:_ CITY: O 6 a- STATE: U C,�- ZIP:
Is'PHONE: PHONE• -XA -Ig1P CELL:
2°d PHONE:_ EMAIL :
EMAIL,-�Q _l�S" 1cVi'\ C�Q�►'� L&I REG#1GtUf JGq(
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number):_���3 p���—, ���� Zoning: (Z
LEGAL DESCRIPTION(Abbreviated):et-i� Y\t:��,�31v•�i ,? �r�� o'�C� 5 alc—�Oei
SITE ADDRESS: eOAQ-C %,WN CITY: aAf3�e jjtyx ]
DIRECTIONS TO SITE ADDRESS:
)� - Uri h}\\ CLA6- % akre.,d�r l,r. .ate\\ kn��F h\U L = h �
TYPE OF JOB:
NEW_)C—ADD ALT REPAIR OTHER USE OF BUILDING �( t fY\(}xg R-�%C).r1CQ,
LOCATION OF FIXTURES/UNITS-1ST FLOOR_C_2"DFLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS /
TV e of Fixture No.of Fixtures Fees Fuel Type:Electric)CLPG Natural Gas Ductless
Toilets 1 Type of Unit No.o_ fl� Fees
Bathroom Sink Furnace
Bath Tubs Heat Pump
Showers WI'(7C� Spot Vent Fan
Water Heater 1 Propane Tank
Clothes Washer 1 Gas Outlets _
Kitchen Sinks 1 Wood/Gas/Pellet Stove—ISZ—
Dishwasher Kitchen Exhaust Hood
Hose bibs 2011 Dryer Vent 1
Other Solar Panel _
Other 2�—
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER acknowledge 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,owners legal representative, or contractor. 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 authorized agent 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 permit/application becomes null&void
if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INVALIDATE THE APPLICATION. '
c 0 b m► tl:6(d
X J-,Aj", 4M-w) tJ;&h,0
Signature of Owner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT J TL •z 2� Z
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN
Abdelouahab Abrous, Ph.D., P.E.
HiLine Homes
11306 62nd Ave E
Puyallup,WA 98373
(253) 770-2244 x2132
December 29, 2020
Grays Harbor County
Building Division
100 West Broadway,Ste 31
Montesano, WA 98563
Re: Uplift Connector for one end of Truss A01
JOB #: 1002-1513
PLAN #: 897
Owner(s): Seth Parson
This letter addresses the project at 280 E Lavender Ln Shelton, WA 98584. The
issue raised is concerning the truss A01 uplift connectors. Uplift loads are 648-1b
and 596-lb at the ends of the truss. Simpson H10 was used at one end and
Simpson A35 anchor was used at the other end. The uplift capacity of the H10
connector is adequate to resist the uplift load but the A35 is inadequate.
As a remedy, install (1) Simpson SDWC15600 truss screw in addition to the
existing A35 anchor to develop the needed uplift capacity. The Strong-Drive
SDWC screw is to be installed per manufacturer's instructions, i.e, driven
through both bottom plates and into the bottom chord of the truss to provide a
secure connection.
12/29/2020
Please contact me if you have any questions. p,HA g
o� WASy��.p0
Sincerely, _ 0
- 3-
51t0 �t4
1StER�-�
Abdelouahab Abrous, Ph.D., P.E. �Ss/ONA%��-�G
I
troperty Addrart � • ,,
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Job Truss Truss Type Qty Ply
2489974 A01 GABLE 1 1
Job Reference(optional)
Builders First Source,Arlington,WA 98223 8.420 s Sep 14 2020 MiTek Industries,Inc. Mon Dec 14 16:31:15 2020 Page 1
I D:KulYCZL2ZAssjm74ZV660bzCJe6-uag WrdoCseSR_iwM?hwOAItHL371?RmdQK9j5cy8zEg
-1-4-0 2-9-14 13-" 23-2-2 2679-0 1
1 ji-0 2-9-14 10-2-2 10-2-2 2-9-14 14-0
Scale=1:47.1
7x10 MT18HS 11
3x6 11 3x6 11
11 13 15
9 17
5.00 12 7 19
5 21
5x8_�_' 5x8
31 4 14 6 18 22 23
32
3 le
24 0
r
2 25
1 26Iq
0 0
29
3x8= 30 28 27 3x8=
3x4= 4x6 3x8= 3x4=
13-0-0 26-0-0
1-4-0 26-0-0 14-0
Plate Offsets(X,Y)— [2:0-0-9,0-0-11,[4:0-1-8,0-2-81,[13:0-2-1,0-3-71,[23:0-1-8,0-2-81,[25:0-0-9,0-0-11
LOADING (psf) SPACING- 2-0-0 CSI. DEFL. in (loc) I/deft L/d PLATES GRIP
TCLL 30.0 Plate Grip DOL 1.15 TC 0.39 Vert(LL) -0.12 28-30 >999 240 MT20 220/195
(Roof Snow=30.0) Lumber DOL 1.15 BC 0.58 Vert(CT) -0.24 28-30 >999 180 MT18HS 220/195
TCDL 10.0 Rep Stress Incr NO WB 0.37 Horz(CT) 0.08 25 n/a n/a
BCLL 0.0 Code IRC2015/TPI2014 Matrix-SH Weight:165 lb FT=20%
BCDL 10.0
LUMBER- BRACING-
TOP CHORD 2x4 DF 180OF 1.6E*Except` TOP CHORD Structural wood sheathing directly applied or 4-4-1 oc pudins.
4-23:2x6 DF No.2 BOT CHORD Rigid ceiling directly applied or 4-10-12 oc bracing.
BOT CHORD 2x4 DF No.2*Except* JOINTS 1 Brace at Jt(s):14,10,6,18,22
25-29:2x4 DF 180OF 1.6E
WEBS 2x4 DF No.2
OTHERS 2x4 DF No.2
REACTIONS. (lb/size) 2=1402/0-5-8,25=1402/0-5-8
Max Horz 2=-156(LC 49)
Max Uplift 2=876(1_13 38),25=-876(LC 41)
Max Grav 2=1459(LC 25),25=1459(LC 24)
FORCES. (lb)-Max.Comp./Max.Ten.-All forces 250(lb)or less except when shown.
TOP CHORD 2-3=-2845/1703,3-31=2672/1511,4-31=2480/1345,4-5=-1499/929,5-7=-1322f762,
7-9=-1256/688,9-11=-1295/629,11-13=-1091/475,13-15=-1091/475,15-17=-1295/629,
17-19=-1256/688,19-21=-13221763,21-23=-1499/930,23-32=-2480/1346,
24-32=-2672/1512,24-25=2845/1706,4-6=-1021/327,6-8=1026/328,8-10=-1026/328,
10-12=-1026/328,12-14=-1026/328,14-16=1026/328,16-18=-1026/328,18-20=1026/328,
20-22=-1026/328,22-23=-1021/326
BOT CHORD 2-30=-1623/2501,29-30=-1303/2326,28-29=845/2304,27-28=1149/2326,
25-27=-1470/2501
WEBS 4-28=-370/260,14-28=0/362,23-28=-370/261,11-12=-155/425,15-16=-155/425
NOTES-
1)Wind:ASCE 7-10;Vult=140mph Vasd=111mph;TCDL=4.2psf;BCDL=4.8psf;h=25ft;Cat.11;Exp C;Enclosed;MWFRS(envelope)
gable end zone;cantilever left and right exposed;end vertical left and right exposed;Lumber DOL=1.60 plate grip DOL=1.60jjjTN(
2) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind(normal to the face),see Standard Industry
Gable End Details as applicable,or consult qualified building designer as per ANSI/TPI 1. OWAS
�Y
3)TCLL:ASCE 7-10;Pf=30.0 psf(flat roof snow);Category II;Exp C;Fully Exp.;Ct=1.10 lti (i
4)Unbalanced snow loads have been considered for this design.
5)This truss has been designed for greater of min roof live load of 20.0 psf or 2.00 times flat roof load of 30.0 psf on overhangs
non-concurrent with other live loads.
6)Provide adequate drainage to prevent water ponding.
7)All plates are MT20 plates unless otherwise indicated. Y4 c
8)All plates are 2x4 MT20 unless otherwise indicated. �p + 54074 �J
9)Gable studs spaced at 1-4-0 oc. IFS Ig
10)This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads.
11)'This truss has been designed for a live load of 20.Opsf on the bottom chord in all areas where a rectangle 3-6-0 tall by 2-0-0 wide
will fit between the bottom chord and any other members.
12) Provide mechanical connection(by others)of truss to bearing plate capable of withstanding 876 lb uplift at joint 2 and 876 lb uplift at December 14,2020
joint 25.
WARNING-Verify design parameters and READ NOTES ON THIS AND INCLUDED MITEK REFERENCE PAGE Mll-7473 rev.5/19/2020 BEFORE USE.
Design valid for use only with MiTek®connectors.This design is based only upon parameters shown,and is for an individual building component,not �tl a truss system.Before use,the building designer must verify the applicability of design parameters and properly incorporate this design into the overall
building design. Bracing indicated is to prevent buckling of individual truss web and/or chord members only.Additional temporary and permanent bracing M%�E '
is always required for stability and to prevent collapse with possible personal injury and property damage. For general guidance regarding the
fabrication,storage,delivery,erection and bracing of trusses and truss systems,see ANSYTP11 Quality Criteria,DSB-89 and BCSI Building Component 250 Klug Circle
Safety Information available from Truss Plate Institute,2670 Crain Highway,Suite 203 Waldorf,MD 20601 Corona,CA 92880
Job Truss Truss Type Qty Ply
2489974 A01 GABLE 1 1
Job Reference(optional)
Builders First Source,Ariington,WA 98223 8.420 s Sep 14 2020 MiTek Industries,Inc. Mon Dec 14 16:31:16 2020 Page 2
ID:KulYCZL2ZAssjm74ZV660bzCJe6-MmEugzpgdyalbsVZYORFjzQS5TTXku?mf uGd2y8zEf
NOTES-
13)This truss is designed in accordance with the 2015 International Residential Code sections R502.11.1 and R802.10.2 and referenced standard ANSI/TPI 1.
14)This truss has been designed for a total drag load of 1700 lb.Lumber DOL=(1.33)Plate grip DOL=(1.33) Connect truss to resist drag loads along bottom chord from 0-0-0
to 26-0-0 for 65.4 plf.
15)Graphical pudin representation does not depict the size or the orientation of the purlin along the top and/or bottom chord.
LOAD CASE(S) Standard
mosonsomom
WARNING-Verify design parameters and READ NOTES ON THIS AND INCLUDED MITEK REFERENCE PAGE MII-7473 rev.5/19/2020 BEFORE USE.
Design valid for use only with MiTek®connectors.This design is based only upon parameters shown,and is for an individual building component,not
a truss system.Before use,the building designer must verify the applicability of design parameters and properly incorporate this design into the overall
building design. Bracing indicated is to prevent buckling of individual truss web and/or chord members only.Additional temporary and permanent bracing M!T@�{'
is always required for stability and to prevent collapse with possible personal injury and property damage. For general guidance regarding the r�
fabrication,storage,delivery,erection and bracing of trusses and truss systems,see ANS11TP/1 Quality Criteria,DSB-89 and BCSI Building Component 250 Klug Circle
Safety Information available from Truss Plate Institute,2670 Crain Highway,Suite 203 Waldorf,MD 20601 Corona,CA 92880
MASON COUNTY Mason County Permit Center Use:
COMMUNITY SERVICES
ADV 2A 2D - (.Ya0r0
G< Building,Planning,Environmental Health,Community Health
615 W.Alder St.—Bldg.8,Shelton;Wa 98584 Date Rcvd
Phone:(360)427-9670 ext.352♦ Fax:(360)427-7798
Fee: $130.00
Request for Administrative Variance for
Reduction in the Required Setbacks
For administrative review,the minimum variance on a setback request is 5 feet from the side yard lot
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the furthest projection of the structure,
including roof eaves and gutter
Applicant/Owners: J�JI�f/ 11.1�1J�11�1
Mailing Address: FzAl
City: 5h"n State: Zip: �S�T
Telephone: ?APO - 2a 1"Acilf
Email: ��
If this reduction is tied to a building permit, please give permit case number.
BLD zr720 - OCkS�?a
Parcel Number(s): 321 A D .6 Zoning 6 h-
Site Address: 7�(�� LA\t")d Lr L&4q
Requested setback variance:
ft. Front ❑ Rear ❑ Side
, ft ❑ Front ❑ Rear ,Side
ft. ❑ Front ❑ Rear ❑ Side
ft ❑ Front ❑ Rear ❑ Side
Front Setbacks—From access easements and road right of ways.-Minimum 10 feet.
Rear Setbacks—From the rear property line. Minimum 10 feet.
Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations.
An illustrated site plan is required.
Your site plan must show the following: north.arrow, abutting street or easements, and set backs to all
property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and
driveway. Show all proposed new development.
FRONT AND'OR REAR YARD REDUCTION RE UESTS:
For ng lots of record as of March 5,2002;
You must meet one of the following:
1) One of the following exists on the lot(check all that apply):
❑ a} steep slopes,wetlands or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
`❑ ji) lot size of no more than one-fourth acre;
e) existing improvements of buildings,septic systems,and well areas.
SEVE YARD REDUCTION REQUESTS:
F r exi ' g lots of record as of March 5,2002;
You must meet one of the following:
4 2) One of the following exists on the lot(check all that apply):
❑ a) steep slopes,wetlands,or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-half acre;
e) existing improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10,or 20 zones.
ge, n V
Owner/Agent(please indicate) ( O an
Signature Date
OtIcia!Use Only
Approved by: �I 1 t 1.1 1�� Date
Denied by: Date
Reason for denial:
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