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U cod} ' 141 A3e � � 1; 4) S � /uo-L- t 2 3 Aor is & AI r 6,AdV TRW �'E Sa �_ ,�',Ev ►� fu, Zt i f L A41 L r; r �}v 6 C, c. aa, �l #tkc- Ce- lei PERMIT NO.: BLD-ti(P-j l MASON COUNTY II BUILDING PERMIT APPLI ATION 426 W.Ced ar/P.O.Box 186 Shelton,WA 8584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5 69 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACT R INFORMATION Owner Contractor Name Mailing Address Mailing Address_ City State Zip Code City State Zip Code Phone(_ Other Ph.( ) Ph,(_ Other Ph.(_� Lien/Title Holder Contractor Reg. # Address Expiration SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System PARCEL INFORMATION-12 digit Tax Parcel No't .F®0 / / Fire District Legal Description Site Address(Please include street name, street number and city) Directions to site Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water (Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE a SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Repair Other Use of Building Describe Work No. of Bedrooms No. of Bat rooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No. ol Bedrooms No. of Bathrooms Type of Heat Purchase Price $ 1Replacement Unit ?(Yes/No) Installer Name Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. Th owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTORS AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in onformance therewith. No changes shall be made without approval. first obtaining approval. X Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by - � 'c. Date Submittal Amount Due Receipt No. D.EPARTtVIENTAI. RUI'PW APPROVED DENIED. -C I,I CONDITI'+JN C{3DE5 Building Department v�{7ot•c)a 1:* vr Occ Group ° Type Constr. Planning Departnitnt Environmental Health Department Public Works Department I Fire Marshal Valuation $s � — FEES 3d FBuildingPermitFee �b Site Inspectioniew Fee �� EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee L b� Violation Fee Pre-Paid at Sub ittal ( 3� ) TOTAL FEES 'mum:�i��i022 J3a:d:i w.,7«prip77.�.r. . ram, •yir�r* _•,. +, fa. - Y 1�:3 r S"'i�t dr 7• .F agayr`rj�i3..,m�y/yy� 3eA)tilm/:,.���' �zy.,y��a�+•�'��9�t��.y,.�1�ya����1aS�� di; �lp7ryfyL��a ((i_ .rjtdi�5r�{u�yi��s:��y{T1y g4ll yiliy y��LgdLy6�Nhr.J 7�_fSyl�3l�i'iii%Yr9�i�,I,iR�i��y��ay4ywlit./a�,�ylltl �'a� 7i z��agY.3��g ®9 pi�p�fp�Qdi yWa+.�i`; iS�iyO�.}i�i:��t1� Myya�7l�i�Y�Mt�ei��"v •.,�q..i."id 7A+ A'Ssi!'Jf�/dc-YRiBii: itii1 .1+YR.�id.7e�5➢[t���ai�.-'aciliJne�el iVANieliw�iaefm��l��el�l�'d aaiii�ii"�5i� ® e�ei�eielae�i ME t � i� I, • s - t. e r 3 i•3 iim�� 411AQg4slli �i II No i 1P�0� CATFo� MASON COUNTY A o N DEPARTMENT OF COMMUNITY DEVELOPMENT o N Planning Division o N V o~ P O Box 279, Shelton, WA 98584 1854 (360)427 9670 NOTIFICATION OF INCOMPLETE APPLICATION February 13, 2002 DONALD DUMONTET 4471 W DAYTON AIRPORT RD S H E LTO N WA 98584 Parcel No.: 420081300030 Project Description CARPORT Dear Applicant: You have submitted a permit application (case no. BLD2002-00090) for proposed construction or development in the county. Upon review of your application, I have determined that the contents of the application are incomplete or do not provide enough detail for review. Therefore, review of your application will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is submitted and the application is complete, I will continue to process your application accordingly. Please contact me at (360) 427-9670, ext. 577 if you have questions, Si cer , Rick Mraz Land Use Planner Mason County Planning Department i 2/13/02 1 of 2 BLD2 02-00090 NOTIFICATION OF INCOMPLETE APPLICATION 2/13/02 Case No.: BLD2002-00090 Comments A site inspection of the subject property as conducted on 2/6/02 with the following results: The existing carport, constructed without a building permit or site review, is approximately 61 feet from a hype V stream (per Washington Department of Natural Resources stream typing criteria). The Fish and Wildlife Habitat Conservation Area chapter of the Mason County Resource Ordinance requires a 90-foot buffer (75 foot undisturbed vegetative buffer + 15 foot building setback) from Type V streams. Existing construction is grandfathered and not subject to the provisions of the Resource Ordinance (RO). However, proposed new construction is required to comply with the provisions of the RO. A variance from the Fish and Wildlife Ha itat Conservation Areas chapter is necessary to permit this project. A Habitat Management Plan (HMP), prepared by a qualified biologist, is required to support the variance request. The HMP addresses impacts to the buffer and offers measures to preserve and protect the buffer or mitigate impacts. A copy of the Fish and Wildlife Habitat Conservation Areas chapter is enclosed. It includes details on the contents of an HMP. It also contains information about the variance procedure. I have also enclosell a variance application. If you have any questions or require clarification on any of these issues, please contact me. 2/13/02 2 of 2 BLD 02-00090