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Home My WebLink AboutMEP2012-00031 - MEP Application - 8/24/2012 MASON ENVIRONMENTAL PERMIT $63 r$380 w/other permit) Mason County Permit Center Use: ❑ CONDITIONAL USE($1520) MEP 7 0 1 Z - ❑ HABITAT MANAGEMENT PLAN REVIEW($445) Date Rcvd MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Resource Ordinance(Chapter 17.01 MCC) ENVIRONMENTAL PERMIT APPLICATION The purpose of the Resource Ordinance is to protect Mason County's natural resource lands and critical areas and is under the authority of Chapters 36.32,36.70A,39.34, 58.17,76.09, 84.33,84.34 and 90.58 RCW. PLEASE PRINT 1.PROPERTY OWNER Name: CW C-"5 vh CX- Mailing Address: �\1 rvw r vt�l Work Phone: 0,kD—j 0 -"� WP\ Email Address: Home/Cell Phone: 5�'1—��\ Fax#: If an agent is acting for the property owner during the permit process,complete#2. 2.AUTHORIZED AGENT Name: Mailing Address: Cj� ,,,.� p q J-0-,uQ Q. Work Phone: Email Address: Home/Cell Phone: Fax# 3.PROJECT SITE C'`' C'✓cam R�� Site Address: 15 ,0G0,j A —T`P Cc"� Zvlkc} 01441 " Parcel#: �'a-'��b - V�� - 04000 Legal Description: Q-TW `C L- (6'�- Ctnl TL. Directions to Site: V1 r2 \ OrIJQ� 1 Wi� 6`n SR 7 f ��hT �h. �u✓t .� Attach a site plan showing the following: Lot Dimensions,Flood Zones,Existing Structures,Fences, Water Lines,Driveways,Drainage Plans,Shorelines,Septic System,Topography,Proposed Improvements,Easements,North Arrow,and Scale. Also draw a separate topography diagram. I.',Conuuunil Development\PAC\MEP Page 1 of Revised June 2010 4. State which section requires permit: ❑ Long Term Commercial Forest,Chapter 17.10.060 ❑ Frequently Flooded Areas,Chapter 17.01.090 ❑ Mineral Resource Lands,Chapter 17.01.066 ❑ Landslide Hazard Area,Chapter 17.01.100 ❑ Aquifer Recharge Area,Chapter 17.01.080 ❑ Seismic Hazard Areas,Chapter 17.01.102 ❑ Erosion Hazard Area,Chapter 17.01.104 ❑ Fish&Wildlife Habitat Conservation Areas,Chapter ❑ In-Holding Lands,Chapter 17.01.062 17.01.110 18 Wetlands,Chapter 17.01.070 5. Identify current use of the property with existing improvements: ff nrC rife-St./VL /1n3 4') J`^ k-LL Qj�tQ 6. Identify and describe the proposed project,including the type of materials to be used,construction methods, principle dimensions,and other pertinent information(attach additional sheets,if,needed): QcT \1n�1 J�Vc S A1G�J ° A CA S 1f�'B Q aN V LakeV 7. Describe why the action requiring this permit cannot be avoided. �or� \5 .ir'Ltu VO Qrov• Qv.��;c. �cceSS �-c� ��- QArk. 8. Will there be an alteration of a wetland and/or wetland vegetation area(circle one)? Yes No 9. Identify any surface water on or adjacent to property(circle one): Saltwater Lake Stream Pond Wetland Drainage Ditch 10. Identify existing septic/sewer connection(circle one): If septic is located on project site,include records. "r r Connected to Septic Connected to Community Septic 11. Identify existing water supply(circle one): Public Water Supply Well 11. Type of Job(circle one): New Add Alteration Repair Demolition Other: Print Name Sig atu a Date I:ACommunity Development\PAC\MEP Paee 2 o _ Revised June 2010 MASON ENVIRONMENTAL PERMIT($630 or$380 w/other permit) Mason County Permit Center Use: ❑ CONDITIONAL USE($1520) MEP ❑ HABITAT MANAGEMENT PLAN REVIEW($445) Date Rcvd MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Resource Ordinance(Chapter 17.01 MCC) ENVIRONMENTAL PERMIT APPLICATION The purpose of the Resource Ordinance is to protect Mason County's natural resource lands and critical areas and is under the authority of Chapters 36.32,36.70A,39.34, 58.17,76.09, 84.33, 84.34 and 90.58 RCW. PLEASE PRINT 1. PROPERTY OWNER n Name: W Cn5 M C,_rt� PPt l 11.'� Mailing Address: 0 r 5 tom- S Work Phone: 3��—�','1—ej�'1� ��°� Email Address: NJ Home/Cell Phone: Fax#: If an agent is acting for the property owner during the permit process, complete#2. 2.AUTHORIZED AGENT Name: C-7 c� Mailing Address: Work Phone: Email Address: Home/Cell Phone: Fax# 3.PROJECT SITE Site Address: Parcel#: a.�.��, - �y - 0 O p p p Legal Description: v LO�. 1 Directions to Site: �Y NM S�� O ✓v�o�Kn �� 1 5�� INQ Ro 9 Ph�k H t 5 �,lr �w.•�is uv. � �n�. Attach a site plan showing the following: Lot Dimensions,Flood Zones,Existing Structures,Fences, Water Lines,Driveways,Drainage Plans,Shorelines,Septic System,Topography,Proposed Improvements,Easements,North Arrow,and Scale. Also draw a separate topography diagram. 1ACommunity Development\PACMEP Page 1 of 2 Revised Jwie 2010 4. State which section requires permit: ❑ Long Term Commercial Forest,Chapter 17.10.060 ❑ Frequently Flooded Areas,Chapter 17.01.090 ❑ Mineral Resource Lands,Chapter 17.01.066 ❑ Landslide Hazard Area,Chapter 17.01.100 ❑ Aquifer Recharge Area,Chapter 17.01.080 ❑ Seismic Hazard Areas,Chapter 17.01.102 ❑ Erosion Hazard Area,Chapter 17.01.104 ❑ Fish&Wildlife Habitat Conservation Areas,Chapter ❑ In-Holding Lands,Chapter 17.01.062 17.01.110 ❑ Wetlands,Chapter 17.01.070 5. Identify current use of the property with existing improvements: e� c .c. QVJ 6. Identify and describe the proposed project,including the type of materials to be used,construction methods, principle dimensions,and other pertinent information(attach additional sheets,if needed): n S�nnn�A (3A-AL- \-,X. Lrvs\,A A-R%)Av- k q welsh Qo0". A Vah\V 'Tay1Lk- w►1L AtSo r,S ty , 7. Describe why the action requiring this permit cannot be avoided. 8. Will there be an alteration of a wetland and/or wetland vegetation area(circle one)? CE:> No 9. Identify any surface water on or adjacent to property(circle one): Saltwater Lake Stream5 Pond Wetland Drainage Ditch 10. Identify existing septic/sewer connection(circle one): If septic is locat d on project site,include records. Connected to Septic Connected to Community Septic 1 ` 1 11. Identify existing water supply(circle one): Public Water Supply Well ND V 11. Type of Job (circle one): New Add Alteration Repair Demolition Other: Q� -Av, 4a3-1 Print Name Si atu a Date I:\Community Development\PAOMEP Page 2 Revised June 2010 1 � i North Bay Trail Coulter Creek Property 6-tt culvert /� __-•._. _._._._._._.._.North Bay Rd _-- ... r 1 t -gait IWO 1 �,.•*v -Fraithoad rn 3 .s•"'fit' Parking (10-452 cars) i � � � • B©ardwaEk Compacted t 'f'-ails gravel path Water Access r faotbrid O 9 Vic-wing Old enCfnes ithway A .;jJ.rucv �s•+�� ♦' +�._ A►'"4at 1nt4rprativa Nub • `ram yvstie •` ReStrOOm �- I hail EVlap ( �. Cfeanng 1ErrvvrsY _• 'sir `rraerker ._ �•r•.aas.4.a.er�w. 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