HomeMy WebLinkAboutGRD2019-00011 - GRD Permit / Conditions - 1/7/2020 o� Sao
MASON COUNTY PERMIT NO. �t
DEPARTMENT OF COMMUNITY DEVELOPMENT II
BUILDING•PLANNING•FIRE MARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton V5
Mason County Bldg. 8, (360)275-4467 Belfair ex
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rx;d 615 W.Alder Street,Shelton,WA 98584 (360)482-5269 Elma ext.35 C' ED
LAND MODIFICATION PERMIT (Grading Permit) OCT 112019
OWNER INFORMATION: CONTRACTOR INFORMATI • N. Alder Stre
t
NAME: Aaron Nix NAME: Quigg Brothers,Inc.
MAILING ADDRESS: 3740 N Lake Cushman Rd MAILING ADDRESS: 819 W State St
CITY: Hoodsport STATE: WA ZIP: 98548 CITY: Aberdeen STATE: WA ZIP: 98520
PHONE:(360)877-5233 x18 CELL: PHONE: (360)533-1530 CELL:
EMAIL: anix@lakecushmanmc.com EMAIL :-qb@quiggbros.com
L&I REG# QUIGGBI022RT EXP. 01/ 29/20
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) 42209-88-88888 FIRE DISTRICT 18
LEGAL DESCRIPTION(ABBREVIATED) : City of Tacoma Transmission Line ROW
SITE ADDRESS ±530 NE Duckabush Dr.(no site address for parcel) CITY Hoodsport
DIRECTIONS TO SITE ADDRESS From US 101 intersection with SR 119 in Hoodsport:travel west on SR 119 3.7 miles,turn
left at Duckabush Way,and immediately turn a on NE Duc us Dr. Stay on Duc a us Way or approximate y 0.6 mi es,and
gr cu 1 1''1y�V 1 IR1 �fmiss�on me grave roa i e is approxima e y ee rom uc a rus r.
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM❑
DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES❑ NO ❑X
WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES ❑ NO 0
TYPE OF JOB: EXCAVATION ❑ FILLING X❑ GRADING X❑ CUTTING ❑ OTHER ❑
TOTAL SIZE OF PARCEL 175'wide ROW ACRES/SQ FT SIZE OF AREA TO BE EFFECTED0.45/20,000ACRES/SQ FT
ESTIMATED AMOUNTY OF CUBIC YARDS 1,100 Cy
DOES THE SITE HAVE SLOPES 14%OR GREATER YES❑ NOD
DESCRIBE SCOPE OF WORK Temporary excavation spoils stockpile associated with the recent Goldeneye Drive culvert
replacement project will be spread into a permanent stockpile in the Tacoma Transmission Line ROW.
WILL FILL BE BROUGHT ON SITE? IF YES,SITE ADDRESS: From Goldeneye culvert replacement,131 N Goldeneye Dr.
WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS:
DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES ❑ NO 0
HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES ❑ NO 0
WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES ❑ NO ❑X
WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES ❑ NO ❑X
WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES ❑ NO❑X
WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES ❑ NO ❑X
WILL THE LAND BE REPLANTED UPON COMPLETION? YES ❑X NO❑
WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES ❑ NO❑X
IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES ❑ NO N
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
INSPEQf ION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILLJNVALIDATE THE APPLICATION.
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nS_y✓CD�/� 0 . Mignature o Applicant 'Date
X �tT, IX OWNER/REPRESENTATIVE/CONTRACTOR
�-Print Name (CIRCLE TO INDICATE)