HomeMy WebLinkAboutBLD CD Environmental Health Review - 5/18/2023 MASON COUNTY Permit No:' f/IGI20 25 -005(O�J
COMMUNITY DEVEL PMENUCEIVED
Permit Assistance Center, Building,Planning y� Y 18 2023
BUILDING PERMIT APPLIC IOI�Y15 W. Alder Street12
PROPERTY OWNER INFORMATION: CONTRACT TION T
NAME: fi-Ank.A"flS14zeAW6 bUMNkA NAME: Lra , c n
MAILING ADDRESS: 1, MARdNG ADDRESS:
CITY: G STATE: _ P: CITY: STATE:_Z�:
PHONE#1: d CELL:
PHONE#2: EMAIL: p ,
} tdtdi a
EMAIL: L&I REG# /_/_ }
PRIMARY CONTACT: OrM)d CONTRACTORX OTHER)d�IL' besdj
NAME Fharlk - Me re�nl�A EMAIL M
MAILING DRESS CITY—STATE—
PHONE CELL
PARCEL INFORMATION:PARCEL NUMBER(12 Digit Number) 79 " ggg, ZONING Slfifk, Atli ^]S
LEGAL DESCRIPTION(Abbreviate FIRE DISTRICr AS
SITE ADDRESS 741 WE EI4[k$ SF S 679
DIRECTIONS TO SITE ADDRESS�p r
&NE S L �
t5 THE MontT WITHIN 300 Ft OF SLbFE(S)GREATER :THAN 14i YES❑ NO� S OW LOAD: 25 pi
IS PROPERTY WITFUN 200 FT OF THE FOLLOWING: (chafed a *EEtyJ:
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER XI I(SAa}yL—
USE OF STRUCTURE (Rrrdsnrz,Geroge Ca eare fat Ek.)
IS USE: PRBNARY(g SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS 2,
HEATEO STRUC URE? VES(wnouflwX YES(Earrjs%geicg) ❑ NO❑
DESCRIBE WORK I i 4= Usd 140 1St•
SOUARE FOOTAGE: mrp^" p _
1ST FLOOR & 2ND FLOOR sq.ft 3RD FLOOR si fL BACTTFFIa'r q.
s ft•
DECK I.fL COVEIt.FfIDECK Sq :__sq.R STORAGE sq.ft. UTAF1Ft " 'r"9q. i
GARAGE sq.R Attached Q Detached Q CARPORT sq.R Attached Q Detached Q
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE Flerl-ulenA MODEL 4r"4ml YEAR1gli LENGTH (i b.<
WR)TH 131Ll BEDROOMS_2 BATHS .1, SERIAL NUMBER wavL_ag3�3�4n �»
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC Dr ❑
PLUMBING IN STRUCTURE? YES§d'G NO❑ IJyes,attach completed Wai Adequacy Form
PERIMETERNOUNDATION DRAINS PROPOSED? YES[I NM EXISTING SQ.FT.
EXISTING 13ED1OOMS_2__ PROPOSED BEDROOMS--A _ TOTAL BEDROOMS L
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Aulmoisedgemem of such Is by
N mined YCUW. YYI:o W YIN I necessary
awwv.YHY I including
a W W so I nt older or
btl1tlW IHb PCMIe pre M 1tp s p Wqk The
mvma t fl g
obtained pertnasion from all the necessary parties,including any easement holder or pelves of interest regarding this project The owner a legal
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Well radio ss for 2N 79-90669 / t
d el 184.83'
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property \ ;m TP. A'1� a�F��ai+s a10
wetlands are 150'off zdsgn 1 Parking& / 4.Sots O`s�a
0 Turnaround ,�/
the northwest property a a Area
comer,270'from the n
proposed structure / ,t, '""•• g/
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Pump............. / • N ��
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ank.�
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Downspout Drainage t
Line to daylight `,' " @t a'.y1 a Planned
Rain Garden/
Runoff
..i a�J d°a ;Well Retention
. �aeda� House c� Area
V 5 1t oa���vN
0 .� "` Proposed ap p
o Well
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EH APPROVED
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S N li . $. Rhonda Thompson 11/13/2023
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G th CM ' o Building Site Plan Name: Marcinka Tax Parcel: 22310-79-90663
C.C,d Eina
C.N N Scale = I"= 40' Address: 797 NE Blacksmith Br,Belfair
Q o _ " ` �In 2a23 - �5to3
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EH Setbacks
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N A.) DranfielNReserve requires 10'setback from foaling/foundations
B.)Septic tank(s)requires 5'setback from all footing/foundations
C.)No foundation/Perimeter Drains within 30ft,dnwngradient of
Drainfield/Reserve area
D)No Gut Benk)s)(greater than 5n and over 45 degrees)within
5011,down gradient of Drainfield/Reserve area