HomeMy WebLinkAboutBRN2023-00047 - BRN Inspections - 11/1/2023 �++"'�► Mason County
e Mason County - Division of Community Development
615 W.Alder St.
Building 8
Shelton, WA 98584
360-427-9670 ext 352
www.masoncountywa.gov
BRN2023-00047 BURN PERMIT
PROJECT DESCRIPTION: ISSUED: 11/01/2023
SITE ADDRESS: 91 W WEAVER CREEK LN SHELTON
EXPIRES: 12/01/2023
PARCEL: 421192390033
APPLICANT: FRY JEFFERY A&LETTIE M OWNER: FRY JEFFERY A$LETTIE M
PO BOX 1541 PO BOX 1541
SHELTON,WA 98584 SHELTON,WA 98584
CONTACT: DANIEL MANN
6311 SE Arcadia Rd
SHELTON,WA 98584
360.427.9512
FEES: Paid Due
Burn Permit Fee $175.00 $0.00
Totals : $175.00 $0.00
REQUIRED INSPECTIONS
Burn Inspection
CONDITIONS
• All materials must originate from the property on which the burning is to occur.
• Access must be passable with 2 wheel drive vehicle.
" The fire must not create a nuisance from smoke, obscure visibility on public roads and highways, or endanger life and
property-
* Provide EXCAVATOR/DOZER (with fire extinguisher)on site with qualified operator.
• Valid permit MUST be onsite while burning. If permit is not on site during burning the fire will be extinguished at your cost
" Fire must be completely extinguished within three (3)days after ignition.
• Permit includes two(2) inspections maximum, additional inspections will require a re-inspection fee. (at current rate).
* Fan required.
Printed by:Cassidy Perkins on:11/01/2023 11:21 AM
Page 1 of 2
t.
vim Mason County
Mason County - Division of Community Development
615 W. Alder St.
Building 8
lip Shelton, WA 98584
360-427-9670 ext 352
www.masoncountywa.gov
BURN PERMIT BRN2023-00047
* The following materials are prohibited and must not be burned: garbage, dead animals, asphalt, petroleum products,
paints, rubber products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance
(other than natural vegetation)that releases toxic emissions, dense smoke, or obnoxious odors when burned.
* On Site Water is required for permits between April 15th and Oct. 15th. A pump truck or trailer with 300 gallons of water
loaded and
200 ft of hose. (The pump must be capable of pumping 20 gallons per minute through a one inch (diameter)50 foot section
of hose.)
* Each pile must be at least one hundred (100)feet from any structure and at lease fifty(50)feet from standing timber.
* Upon completion of above conditions, applicant must have inspection &approval before ignition. Call (360)427-9670, ext.
262
* After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots.
* *IF BURNING WITHOUT CALLING IN, THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE
SUSPENTION OF PERMIT.*
* A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void. After a
burn ban.
has been implemented, all fires must be extinguished immediately.
* A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must provide 24 hour fire
watch.
* Maximum pile size is twenty(20)feet in diameter, a minimum ten (10)feet firebreak must be constructed around each pile.
* Do not burn if wind is blowing more than seven (7)miles per hour. DO NOT BURN IF WIND BLOWING FROM
* APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY.
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 or not. The granting of a permit does not presume to give authority to violate or cancel
the provisions of any other state/local law regulating construction or the performance of construction.
Issued By:
Contractor or Authorized Agent: A Date:
Printed by:Cassidy Perkins on:11/01/2023 11:21 AM
Page 2 of 2
615 W.Alder St.Bldg 8,SHELTON,WA 98584
f MASON COUNTY SHELTON:360-427-9670,EXT 352
BELFAIR:360-275-4467,EXT 352
COMMUNITY SERVICES ELMA:360-482-5269,EXT 352
Building,Planning,Environmental Health,Community HeaM www.co.mason.wa.us
BURN PERMIT
BRN2023-00047
Issued Date 11/01/2023 Expiration Date 12/01/2023
Parcel Number 421192390033 Fire District
Site Address 91 W WEAVER CREEK LN
Applicant FRY JEFFERY A&LETTIE M
360.427.9512
Contractor License Number
Contractor
Expiration Date
Phone
1.Valid permit MUST be onsite while burning.If permit is not on site during burning the fire will be extinguished at your cost.
2.The following materials are prohibited and must not be burned:garbage,dead animals, asphalt, petroleum products,
paints, rubber products, plastics, paper,cardboard,treated wood,construction/demolition debris, metal or any substance
(other than natural vegetation)that releases toxic emissions,dense smoke,or obnoxious odors when burned.
3.All materials must originate from the property on which the burning is to occur.
4.The fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and
property.
5. Maximum pile size is twenty(20)feet in diameter,a minimum ten(10)feet firebreak must be constructed around each
pile.
6. Each pile must be at least one hundred(100)feet from any structure and at lease fifty(50)feet from standing timber.
7. Do not burn if wind is blowing more than seven(7)miles per hour. DO NOT BURN IF WIND BLOWING FROM
8.A responsible adult and equipment shall be on site and in attendance at the fire while burning.Must provide 24 hour fire
watch.
9.On Site Water is required for permits between April 15th and Oct. 15th.A pump truck or trailer with 300 gallons of water
loaded and 200 ft of hose.(The pump must be capable of pumping 20 gallons per minute through a one inch(diameter)50
foot section of hose.)
10. Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator.
11. Fire must be completely extinguished within three(3)days after ignition
12. Fan required.
13. Upon completion of above conditions,applicant must have inspection&approval before ignition.Call (360)427-9670,
ext.352
14.APPLICANT'S MUST CALL 360.426.4441, EACH DAY TO REPORT BURNING ACTIVITY.
15.APPLICANTS MUST CALL 360.539.7610(ORCCA)EACH DAY TO REPORT/REQUEST ANY AIR QUALITY ISSUES
ASSOCIATED WITH BURNING.
16. IF BURNING WITHOUT CALLING IN,THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE
SUSPENSION OF PERMIT.
17.After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots.
18. It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely
extinguished. The permitted individual is responsible for any rekindling on the fire/burn site.
19.A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a
burn ban has been implemented, all fires must be extinguished immediately.
20. Permit includes two(2)inspections maximum,additional inspections will require a re-inspection fee. (at current rate)
21.Access must be passable with 2 wheel drive vehicle
Official Use Only
Inspector. �> Sketch of Site/Comments:
Date:
Burn Permit #
PARCEL AND SITE INFORMATION:
Parcel within 200'of. Saltwater❑ Lake❑ River/Creek/Stream❑ Pond❑ Wetlands❑ Seasonal Runoff❑ : Yes/None
Slopes or Bluffs> 15%within 50 feet Yes/No Will timber be cut and sold in parcel preparation? QNo
n
Does Site require FPA or 6 yr.Moratorium:Yes/No Is site being converted or replanted:Yes/No
Is site located in an Urban Growth Area(UGA)?:Yes/No/Unknown [Burning is currently NOT allowed inside UGAJ
Zoning`
Summarize proposed land clearing items to be burned:
SITE PLAN
In the space provided below,please draw a top-view site plan of the parcel and notate locations of the following
items with distances to/from"Burn Pile":
o Burn Pile and Feeder Piles
o Any existing buildings/structures(ie:Residence, Garage, Storage shed,Driveway,etc.)
o Existing standing timber
o Any"Critical Areas" such as Steep Slopes,Lake,River/Creek,Wetlands, Seasonal Runoff, Streams,etc
o�OvCj-�
/Ou �-
�-
yr r Co uY
WNEWCONTRACTOR:Acknowledges submission of inaccurate information may result in a stop work order or permit
r vocation.Acknowledgement of such is by signature below.The owner represents that the information provided is accurate and
is employees of Mason County&local fire authorities access to the above described property and structure for review and
i pectl6n.The pe n in charge of the fire will be liable for the cost of suppression if the fire gets out of control or if becomes
necess to exti gu h the e as the result of an enforcement action.
x /I f , "3
SIGNATUR -MUST BE SIGNED BY PROPERTY OWNER Date Signed
FOR OFFICIAL USE ONLY:
PLANNING DEPT REVIEW:
Date: Approved by: Denied by: N/A- No Critical Areas
WEST Jw'jsOjv £IR£ _
Matthew Welander
Fire Chief •
PO Box 2436
Shelton, wq 98584
(360)426-7343 _
Cell:(360)485-3714
rnwelander@mcfdl6.com
Ex(-e/%nce thr
Eduough
cat/on
EXPIRATION DATE: "1. �-' Permit#: BRN 2023 - 00 U
MASON COUNTY BURN PERMIT APPLICATION
615 W Alder St• Shelton,WA 98584
SHELTON 360.427.9670 x352•BELFAIR 360.275.4467 x352•ELMA 360.482.5269 x352
APPLICANT/OWNER INFORMATION: CONTRACTOR INFORMATION:
Owner J,f0 4 L,,- ;c- -r Owner h r z 1
Mailing Address a1 I W bV ra G Cc<k J_Aj Mailing Address 6311 IF- r .'
city 5ke 1 }rv. State_%A)�Zip 4 S, City Skc] State Zip
Phone 340,Zo(o- 4't S 2 Cell Phone Phone 3 j -`(2?-9T 2 Other Phone 360^At Vj-2L31
Lien/Title Holder Contractor Reg.# Exp.
E-mail address + cl�@ k o W�&"l E-mail address . c-vK 4�S - N t a}-
Drivers Lic.#,al(o l3 Q D.O.B. Drivers Lic.# W 0133 fCG 1_0j (3 D.O.B.
TAX PARCEL NUMBER �l �Z3�{�6 33 (12 digit number) Fire District
SITE ADDRESS(please include street name,number&city) q V WC Q V-cf- L r{-t k J IV
Directions(to the site) _
BURNING IS AUTHORIZED SUBJECT TO THE FOLLOWING CONDITIONS:
• Valid permit MUST be onsite while burning.If permit is not on site during burning the fire will be extinguished at your cost.
• The following materials are prohibited and must not be burned: garbage, dead animals, asphalt,petroleum products, paints,rubber
products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural
vegetation)that releases toxic emissions,dense smoke,or obnoxious odors when burned.
• All materials must originate from the property on which the burning is to occur.
• The fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and property.
• Maximum pile size is twenty(20)feet in diameter,a minimum ten(10)feet firebreak must be constructed around each pile.
• Each pile must be at least one hundred(100)feet from any structure and at lease fifty(50)feet from standing timber.
• Do not bum if wind is blowing more than seven(7)miles per hour.DO NOT BURN IF WIND BLOWING FROM
• A responsible adult and equipment shall be on site and in attendance at the fire while burning.Must provide 24 hour fire watch.
• On Site Water is required for permits between April 151 and Oct. 151.A pump truck or trailer with 300 gallons of water loaded and
200 ft of hose.(The pump must be capable of pumping 20 gallons per minute through a one inch(diameter)50 foot section of hose.)
• Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator.
• Fire must be completely extinguished within three(3)days after ignition.
• Fan required.
• Upon completion of above conditions,applicant must have inspection&approval before ignition.Call (360)427-9670,ext.262
• APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY.
• APPLICANTS MUST CALL 360.539.7610(ORCCA) EACH DAY TO REPORT/REQUEST ANY AIR QUALITY ISSUES
ASSOCIATED WITH BURNING.
************IF BURNING WITHOUT CALLING IN,THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE
AND POSSIBLE SUSPENTION OF PERMIT.***************
• After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots.
• It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished. The
permitted individual is responsible for any rekindling on the fire/bum site.
• A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a bum ban
has been implemented,all fires must be extinguished immediately.
• Permit includes two(2)inspections maximum,additional inspections will require a re-inspection fee. (at current rate)
• Access must be passable with 2 wheel drive vehicle
Date Received.
Application continued, please go to next page
Rev.Aor 19.2017