HomeMy WebLinkAboutBLD2023-01422 - BLD CD Environmental Health Review - 11/28/2023 MASON COUNTY PermftNo:Awg0a3-�14?2 m
COMMUNITY DEVELOPMENT Z
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Permit Assistance OE ter,Building,Planning = M
BUILDING PERMIT APPLICATION D Z
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Y11 f➢mo\4T�W4S1 tyE�� NAME: 1,: C ^ II = m
MAILING ADDAE35: - 16 - MAII C ADDRESS iTA ,W, 2 l Z
CITY: STATE:IS'�LZD: GTY: C I) STATE: : : >Ys
PHONE#P 94iy-Q9114 CYW:ke EMAIL:
rrb CELL: 3Ln -s'Yr-vRn D
PHONE#2: 151-110-�1YD (-IlQr�sAl EMAR.: + r
LkI AEG# SE�v��p�oG r5 .IC /3r/z D2023
PRIMARYCONTACT: O"Mil CONTRACro0.p OTHERSTATEJA2lk- N1)PHONE E PARCEL INFORMATION: REC
PARCELNUMWR.(12Di9it Nmabm) 4aan4-SI- ZONDNO
LEOALDESCRIPTION(Abb n,d) I FIRE DISFIUCT
SITEADDRESS [ J CITY
DIRECTIONS TO SITE ADDRESS
RTMPRMC:rMTHI 3N"OFSLOPE(S)GREATERTHANI4%: YESp NOm SNOWLOAD:
TSPR0PERTYWRHIN2MFTOP7IIEFOLLOWING: rta..te "NJ:
SALTWATER[] LAKE❑ RIVBRM, M❑ POND p WETLAND p SEASONAL RUNOFF p STREAM p
TYPE OF WORK: NEW t. ADDITION p ALTERATION,1❑ REPAIR p 011®t n
US60F STRUCNRE(amMmw.rw4.comaralmea.m..) �e< elun..t
ISUSE: PRIMARY{r] SEASONALp NUMBEROFBEDROOMS I NUMBER OF BATHROOMS,_
HEATED STRUCNRB? YESlwnra.Wja ES a/ysleTlp NOp
DB4CRIBE WORK_
SQUARE FOOTAGE:*NP 4
ISFFLOOR 66V q.R 2NDFLOOR 6Y q.R 3RDFLDOR 4D- R.R. BASEMENT '& N.R
DECO & COVEREDDECK q.R. STORAGE H' eq.fl. OTHER120 q.R t70So.
GARAGE_&Hq.R Aua p Deb 0 CARPORT q.A. Aa o Dmamrdp
MANUFAICTURED ROM
/IWORMATION: e#COPIES OPTTIE FLOOR PLAN REQUIXED-
MAKE DEL 2fIFl 3/w Yfi 2oa3 2 LENGTH
WD)T'H"I
-y. BEDROOMS BATHS 1 SERA.NUINBER
ENVIRONMENTAL HEALTH:
SEWAGPISEwgR SOURCE: sE cp- SBwm0 1 NBw❑ =O E O0
PLUMBING INSTRUCTURE? YES NO p !(yea.ar umrined Nano Ade wu Form
PERDIHTERIPOUNDATION DRADIS,PROPOSED? YESp M13 EXISTINGSQ.FT.
EXISTING BBOROOMS PROPOSEDBEDROOMS TOTAL BEDROOMS
MEII sFrcuMbJee thMet4:Yeebn d nam mmnbn mW mw b aaaq xqk OIM w pMmlr rmwaWn.MruMMpe dWlbb/
aaneNa pebx.l Eeclem lnal lem lne wmeranOl luMerOxlem Mellen entllktlbrtWw Hbp�mXaMbEnlMxmkupgw 1.I Xaw
mbaea pemravon xan.n me necee.en wni.a,'�minmaa env a:.m.nl tw.emm pane.a MIemM mq.Onq Xm pmNar.Tn.amrmyN
regeeem *;)%r m,inle In d Ne mmrmsuon provmea la aaurele.M grtm:emplo)eea or Mzem Curnhaxembtlmtlaw a®IM!pcyMly
YIJ MruWM9ror nrlewene Inapecibn. ml:p.rmweppucenon Oecomev null a role Hw.Yn aeuMonxeG mmOUNN b MdannmrrM Wllbi taY
Wn nH xnMiuGon wM Iacuepan4M bra paba N 1804aye.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT 15 BY MEANS OF INSPECTION. INACTNUY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.82)
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SbrbMngl OWNER(MUMW onad by In,OWNES)onad W In,GORIER) Dab
DEPARTMflIiTALREVRWI APPROVED DATE DENIED DATE TACSINOTEWCONDI'1'IONS :�
BUILDMG DEPARTMBfJ'P
PLANNING DEPARTMENT
FREMARSHAL
PUBLIC HEALTH
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EH Setbacks
AJ DralnflBWRiounhe requires 10 saasokfrom fomingdoundatlons
If septic tank(e)requires 5'setti=k from all loolingd a0 oundons
C.)No IoundatlonlPerimeter Drains within 30f1,downgtadient of
Dreinfleki/ninerve area
.- D.)No Cut Bank(s)(greater than 54 and over 45 degrees)within
50g.down gradient of DralnlleWReserve area -- -
f EH APPROVED
Rhonda Thompson 12/22/2023