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Home My WebLink AboutBRN2024-00025 - BRN Inspections - 4/2/2024 00A Mason County Mason County - Division of Community Development 615 W.Alder St. .I Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov FBRN202'4-00025 BURN PERMIT ESCRIPTION: BURN PERMIT ISSUED: 03/29/2024 ESS: N RAINBOW WAY W LAKE CUSHMAN EXPIRES: 09/25/2024 PARCEL: 422165300151 APPLICANT: LAKE CUSHMAN MAINTENANCE CO OWNER: LAKE CUSHMAN MAINTENANCE CO 3740 N LAKE CUSHMAN RD 3740 N LAKE CUSHMAN RD HOODSPORT,WA 98548 HOODSPORT,WA 98548 360-877-9668 FEES: Paid Due Burn Permit Fee $175.00 $0.00 Totals : $175.00 $0.00 REQUIRED INSPECTIONS Burn Inspection �(� M1 CONDITIONS • Permit includes two (2)inspections maximum, additional inspections will require a re-inspection fee. (at current rate). * Do not burn if wind is blowing more than seven (7)miles per hour. DO NOT BURN IF WIND BLOWING FROM * Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator. * 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. * Upon completion of above conditions, applicant must have inspection &approval before ignition. Call (360)427-9670, ext. 352 * Fan required. * Fire must be completely extinguished within three(3)days after ignition. Printed by:Annie Wilson on:03/29/2024 10:02 AM Page 1 of 2 W'WI Mason County Mason County - Division of Community Development 615 W. Alder St. Building 8 Shelton, WA 98584 360427-9670 ext 352 www.masoncountywa.gov BURN PERMIT BRN2024-00025 * 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. * Access must be passable with 2 wheel drive vehicle. * After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots. * The fire must not create a nuisance from smoke, obscure visibility on public roads and highways,or endanger life and property. * Maximum Rpile size is twenty(20)feet in diameter, a minimum ten (10)feet firebreak must be constructed around each pile. * APPLICANT'S M 44 UST CALC360.426.41 EACH DAY TO REPORT BURNING ACTIVITY. R. * A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must provide 24 hour firep watch. * 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. * All materials must originate from the property on which the burning is to occur. * Valid permit MUST be onsite while burning. If permit is not on site during burning the fire will be extinguished at your costA A * *IF BURNING WITHOUT CALLING IN,THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE SUSPENTION OF PERMIT.* 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. Date: Printed by:Annie Wilson on:03/29/2024 10:02 AM Page 2 of 2 EXPIRATION DATE: Permit#: BRN A(7n T 00001S 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 LAKE CUSHMAN MAINTENANCE COMPANY Owner Mailing Address 3740 N LAKE CUSHMAN RD Mailing Address City HOODSPORT State WA Zip 98548 City State Zip Phone 360-877-9668 Cell Phone 360-401-9326 Phone Other Phone Lien/Title Holder LAKE CUSHMAN MAINTENANCE COMPAN Contractor Reg.# Exp. E-mail address JMATHEWS@LAKECUSHMANMC.COM E-mail address Drivers Lic.#WDL6PNT76236 D.O.B.06 23 1973 Drivers Lic.# D.O.B. TAX PARCEL NUMBER 42216-53-00151 (12 digit number) Fire District 18 SITE ADDRESS(please include street name,number&city) NO ADDRESS Directions(to the site From Hoodsport,go west on Lake Cushman Road.Turn left on Lower Lake Road.Take next left onto Rainbow Way E. Follow to where Rainbow Way East&West come together at Cushman Potlatch Road.Take a left.Go BURNING IS AUTHORIZED SUBJECT TO THE FOLLOWING CONDITIONS: • Valid permit MUST be onsite while burning.If permit is not on site duringb uming 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 burn 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 arovide 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 ISSUE_S 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 burn 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 c* Rev.Aor19,2017 Burn Permit # al PARCEL AND SITE INFORMATION: Parcel within 200'of. Saltwater❑ Lake❑ River/Creek/Stream❑ Pond ❑ Wetlands❑ Seasonal Runoff❑ Yes Slopes or Bluffs> 15% Yes IN-6"' Will timber be cut and sold in parcel preparation? Yes/ o 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 lBurning is currently NOT allowed inside UGA/ Zoning: R,9,5 Summarize proposed land clearing items to be burned: WOODY' DEBRIS SITE PLAN (to be verified and approved by Planner) 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": N 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 - -- - - - - - - - - -- - - - - -- - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - -- - - - - -- - �,MQ � gy a)T c) (041 5 v o o ,AA&/11 o b b O v p F.u,al.«s o OWNER/CONTRACTOR: Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.The owner represents that the information provided is accurate and grants employees of Mason County&local fire authorities access to the above described property and structure for review and inspection.The person 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 extinguish the fire as the result of an enforcement action. IGNATURE-MUST BE SIGNED BY PROPERTY OWNER Date Signed FOR OFFICIAL USE ONLY: PLANNING DEPT REVIEW: Approved by&date: Denied by&date: