HomeMy WebLinkAboutFPA 2411494 - FPA Application - 8/23/2007 =-
` WASHINGTON STATE DEPARTMENTOF For DNR Region Office Use Only
Natural Resources FPAIN#: 2412494
Forest Practices Application/Notification Region: S
Western Washington Received Date: g Z3 0?
YOU MUST USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION.
TYPE OR PRINT IN INK.
1. Landowner,Timber Owner,and Operator
Leval Name of LANDOWNER Leval Name of TIMBER OWNER Leval Name of OPERATOR nr
Elma Country Club Same As Landowner Fm MR
contact: John Hill S wa c as L�N de W R
Mailing Address: Mailing Address: Mailing Address:
823 S Anacortes Street Same As Landowner E=XE=MC==1=
SCtML as Land ac.�n Gr
City, State,Zip City,State,Zip City, State,Zip
Burlington,WA 98233-3007 Same As Landowner
Serm,e as f�A+��CduJ n L✓
Phone (360 ) 482 -4235 Phone ( } Phone
S5arx.t 2s L. a.�o�da/K�✓
Email: JHill@sheltonschools.org Email: Same As Landowner Email:
2. Contact person
Contact Person Phone (360 ) 866- 9242
Joe Staley
Email: vvtmoffice@qwest.net
3_ Are you a small forest landowner?
[ ] No. W Yes.If Yes and harvesting/satvaging timber, include a Chec dirt RMAP, unless exempt(see instructions)
4. Are you substituting prescriptions from an approved state or federal conservation agreement or watershed
analysis?
[A No. [ ] Yes. Write"Using Prescriptions`in tables that apply.Attach or reference prescripbonstcrvsswalk on file.
S. What Is the legal description of your forest practice?
'/% (quarter quarter) Section Township Range ENV Tax Parcel Number County
Portion NE 12 19 5 W 519121000000 Mason
6. Have you reviewed this forest practices activity area to determine whether it may involve historic sites ardor
Native American cultural resources?Read the instructions before answering this question.
[ ] No. M Yes. rr��
AUG 2 3 2007
QQ dBW(7-22-07) 1 of 5I�ft1fASHINGTON
FOREST PRACTICE ACTIVITY MAP
TOWNSHIP 19 NORTH HALF 0, RANGE 5 WEST(W.M.)HALF 0, SECTION 12
Application :_ 2412494
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Plebss use the legend tium Me FPA Instruction or provide a list of symbols used.
Monday,August 13,2007 6:18:15 AM
NAD 83
Contour Inte+val:40 Feet
http;//www3.wadnr.gov/dnrapp5/servlct/curn-esri_esrimap.Esrimap?ServieeName=fparsaetbw&ClimtV..- 8/13/2C