HomeMy WebLinkAboutBLD2021-00142 MFG Home ADV2021-00026 - BLD Permit / Conditions - 3/9/2021 � 1
Mason County
Mason County - Division of Community Development
615 W.Alder St. Bldg.8
19 Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
B DD2021-00142 MANUFACTURED HOME
PROJECT DESCRIPTION: INSTALLATION OF NEW MFG HOME ISSUED: 03/09/2021
SITE ADDRESS: 2561 NE TAHUYA BLACKSMITH RD TAHUYA
EXPIRES: 09/05/2021
PARCEL: 223195000905
APPLICANT: FLYNN CHRIS OWNER: FLYNN CHRIS
2561 TAHUYA BLACKSMITH RD 2561 TAHUYA BLACKSMITH RD
TAHUYA,WA98588 TAHUYA,WA98588
360.620.1032
CONTRACTOR: SOUTH SHORE CONSTRUCTION
PO BOX 963
BELFAIR,WA98528
1.360.275.0818
GENERAL CONTRACTOR'S LICENSE: SOUTH SHORE CONSTRUCTION License: SOUTHCH016NL
PO BOX 963 Expires: 02/10/2022
BELFAIR,WA98528
1.360.275.0818
FEES: Paid Due
Building Plan Review/Change of $120.00 $0.00
Use-Onsite Sewage
Technology Surcharge $11.00
State Fee-Residential $6.50
Modular/Manufactured Home $275.00 $0.00
Fee- 1 st half collected at
submittal
Planning Review Fee $240.00 $0.00
Modular/Manufactured Home $275.00
Fee-2nd half collected at ready
to issue
Totals : $635.00 $292.50
REQUIRED INSPECTIONS
Setback Inspection Set-Up Inspection
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Page 1 of 5
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
MANUFACTURED HOME BLD2021-00142
Footing Inspection BLD-Final Inspection
CONDITIONS
" 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.
* The plan review checklist 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.
" 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.
* 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.
* 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.
* 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.
" If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the
instructions of the American National Standards Institute (NCSBCS/ANSI A225.1).
* 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.
* 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.
* 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.
* This permit is for the placement and installation of the manufactured home only and does not imply approval or review for
any other items indicated on the plot plan.
* The foundation/footing must be placed on undisturbed, firm-native soil.
" All property lines shall be clearly identified at the time of foundation inspection.
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Page 2 of 5
Mason County
Mason County - Division of Community Development
615 W.Alder St. Bldg.8
19 Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
MANUFACTURED HOME BLD2021-00142
' 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).
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.
* REQUIRED INSPECTIONS (Footing Inspection-prior to pour(set-up manual must be on-site), Set-up Inspection-prior to
skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required
inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the
prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by
the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable
practices or problems that have been discovered. Until resolution of any/all problems no occupancy (Final Inspection)will be
granted for the residence.
OWN ER/CONTRACTOR(indicate which)
* 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.
* 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.
* 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.
* The installation permit shall be displayed in clear view of the site access road. The approved site plan and other
applicable instructions, including installation instructions, shall be available in this location OR placed in the location
specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions.
* Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is
installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work
shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An
Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each
major part of the installation. RCW43-63B.090
An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD
certification tag or temporarily located in plain site within three feet of the home's front entry. There shall be one certification
tag for each certified installer accounting for the work that each installer performed or installed. Certification number and
signature of the certified installer responsible for each major part of the installation. WAC365-210
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Page 3 of 5
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
MANUFACTURED HOME BLD2021-00142
* 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.
* Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the
structure.
* 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 culverti ng/d itching system or road way.
* 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.
* 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.
* On-site Septic System final installation approval required prior to temporary/final occupancy of the residence.
* 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.
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Mason County
h
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
MANUFACTURED HOME BLD2021-00142
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 not. The granting of a permit does not presume to give authority to violate or cancel
the provisi ns ny other state/local law regulating construction or the performance of construction.
Issued By:
Contractor or Authorized Agent: Date: Z j
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Page 5 of 5
RECEIVED 3Z ia2' 1 -00 r2
Y
JAN 2 7 2021
615 W. Alder Street L
tiLL S CKS ARE MEAS
e ROM THE FURTHEST
f OJECTION OF THE SUILDING
PLANNING
22.5'
Water Water Wat r Water Water
100'RADIUS
6 �� 5' EXISTING
WELL
Fol EXISTING
GARAGE
C/o
4'X6'
LANDING
LPN 1 '
e—U.3d6
4'X6' Y • 'off'
LANDING
N
c ;PROPOSED CHRIS FLYNN
I ' RE& DFVE PARCEL # 22319-50-00905
o ; 2561 NE TAHUYA BLACKSMITH
N � I
M I ;
PLOT PLAN
I
SCALE 1"= 50'
EXISTING N
DRIVE VAY
`
�v
APPROVED
Q�
J MASON COUf�TCOUNTY A DCD PLANNING
E PLAN REQI..'IREJ To BE ON
E
CHANGES SL; ;CST TO APPROVAL
By .
- ----- --- Date Qd�a___S-�U�,/
Name Parcel# 223i% -So -oogeF BLD# ZO Z
Mason County
Department of Community Development Jq/V
Small Parcel Stormwater Management Application/Worksheet (6i of ?0?
-Wer
Per Mason County Code, Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application isrOOt
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.
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.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area * All dimensions in feet
Buildings 40 X 24 = 960
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) 960
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 infiWmtion provided is accurate and employees of Mason County are granted access to the above-
described operty r revie dins ection as may be required.
X Owner/Age Contractor lircle one)Date: 1/15/2021
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
RFC/�
Mason County
Community Services-Building Division ✓AN?j O
MANUFACTURED HOME PLAN REVIEW SPECIFICATIONS ?Q?�
UNIT INFORMATION: Snow Load 25 /der S
FLEETWOOD WESTON SUPER 2021 frAef
Make Model VALUE 24403V Year
Square feet 960 Width 24 Length 40
Single/Double/triple-wide(indicate) NEW or Replacement(indicate)
All footings must be min. 12" below grade within 24"of the skirting when perimeter blocking is
required.
When manufacture specification is not available use ANSI A225.1 or HUD 24 CFR 3285. Must provide
pier plan with reference sections.
' ��34 .Y...
Allowable Pressure(Pound Per Square Foot)No Allowances made for overburden pressure,embedment
depth,water table height,or settlement problems
Soil bearing is assumed at 1500 psi If set-up is using a greater soil bearing capacity a soil
report from a design professional is required
Fill(compact or uncompacted) Compaction Report required through Special analysis
Peat or organic clays Compaction Report required through Special analysis
SET UP SPECIFICATIONS:
cif Manufacturer's Pier Plan
n ANSI A225.1/HUD24 CFR part 3285
FOUNDATION:
Check the type of foundation and attach detail plans from manufacturer's or the ANSI
A225.1/ HUD24 CFR part 3285
71 Pads
0 Continuous concrete footing(runners)
71 Slab
ANCHORING:
O Ground
O Magnum
0 Concrete-2500 PSI
71 J-bolt
0 Expansion bolt
For new units,this information can be obtained from the home retailer or contractor. Previously
owned units, which manufacture's instruction are not available must utilize the ANSI A 225.1/ HUD24
CFR part 3285 code for installation.Washington State law requires that a certified installer install
manufactured homes.
The undersigned I hereby acknowledge he/she does understand that the Mason County submittal and
review processes will be based on the information provided herein and will be verified at time of
ins ction
licant/Deal /Installer(i dicate) Date 1/15/2021
MASON COUNTY COMMUNITY SERVICES Permit No:
PERMIT ASSISTANCE CENTER: u)wt ZJ 21 -o o O 4 S 120
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL A d O 2 ti7_t
j 615 W.Alder Street,Shelton,WA 98584 v w w i 3 a
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
Belfair(360)275-4467•Phone Elma:(360)482-5269
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: CHRIS FLYNN NAME:SOUTH SHORE CONSTRUCTION
MAILING ADDRESS:2561 TAHUYA BLACKSMITH RD MAILING ADDRESS:PO BOX 963
CITY:TAHUYA STATE:WA ZIP: 98588 CITY:BELFAIR STATE: WA ZIP:98528
PHONE#1: 360-620-1032 PHONE:360-275-0818 CELL: ejr
PHONE#2: EMAIL:SOUTHSHORE@Q.COM
EMAIL:ULCHRISFLY@GMA1L.COM L&I REG#SOUTHSC01 6N L EXP. 02/10 /2022
PRIMARY CONTACT: OWNER❑ CONTRACTORIV OTHER❑
NAME EMAIL
MAILING ADDRESS CITY STATEW'
PHONE CELL
PARCEL INFORMATION: Mi
PARCEL NUMBER(12 Digit Number) 22319-50-00905 ZONING RR5
LEGAL DESCRIPTION(Abbreviated) WOOTEN LAKE TRACTS TR B FIRE DISTRICT
SITE ADDRESS 2561 TAHUYA BLACKSMITH RD CITY TAHUYA
DIRECTIONS TO SITE ADDRESS HEAD NON WA-3 21.0 MILES,TURN L AFTER DO ON LEFT.2 MILES.TURN L TO STAY ON WA,300 W 3.3 MILES.TURN R ON BELFAIR
TAHUYA RD 4MILES.TURN R ON NE HAVEN WAY 205 MILES,TURN L ON NE MT VIEW DR.3 MILES.CONTINUE ON TAHUYA BLACKSMITH RD.3 MILES.DESTINATION ON LEFT.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOV SNOW LOAD: 25 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEWV ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Ek•.)RESIDENCE
IS USE: PRIMARY V SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURVI YES(R7roleBWV YES(Pav[sjofBldgl❑ NO❑
DESCRIBE WORK INSTALL NEW MANUFACTURED HOME FOR RESIDENTIAL USE
SQUARE FOOTAGE:(proposed)
1ST FLOOR 960 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.&
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
WESTON SUPER
MAKE FLEETWOOD MODEL VALUE 24403V YEAR 2021 LENGTH40'
WIDTH 24' BEDROOMS 3 BATHS 2 SERIAL NUMBER NIA
ENVIRONMENTAL HEALTH: (,1112 —oU If,d-1
SEWAGEISEWER SOURCE: SEPTIC SEWER❑ / NEW&(- EXISTING❑
PLUMBING IN STRUCTURE'l YES1V NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOV EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
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 permittapplication becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 100 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
Dmusigmd by: COUNTY CODE 14.08.42)
1/16/2021
Ignature of OWNER(Must be signed by the OWNER) Date
DF.PARTMENTA,L REVIEWk �= APPROVED DATE DENIED DATE TAGS/NO.TES/CONDITIONS
BUILDING DEPARTMENT zget-2(
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY Mason County Permit Center Use:
�I COMMUNITY SERVICES ADv 2OZI - 660 210
_-rBuilding,Planning,Environmental Health,Community Health
615 W.Alder St.—Bldg.8,Shelton,Wa 98584 Date Rcvd Z� &I
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 gutters. l
Applicant/Owners: Owly, l��
Mailing Address: d �G-A 111 J
City: State: WA Zip: Ci 815 ZS
Telephone: JlX CI W Zl�� L ��" Z_ J(.0 V ' l q z-
Email:
If this reduction is tied to a building permit, please give permit case number.
BLDIt
Parcel Number(s): Z" - -�LJ 1 Zoning
Site Address:
Requested setback variance: ��
CJ ft. ❑ Front ❑ Rear LY 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.
r
FRONT AND OR REAR YARD REDUCTION REOUESTS:
For existing 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;
Ve
lot size of no more than one-fourth acre;
) existing improvements of buildings, septic systems, and well areas.
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
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;
p' 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.
O r/Agent(p ease indicate) j 2 Z0 Z '
Si a 6ate
Official Use Only
Approved by: Date
Denied by: Date
Reason for denial: