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Home My WebLink AboutBRN2024-00034 - BRN Inspections - 5/2/2024 WE,PA9M Mason County L Mason County - Division of Community Development 615 W.Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BRN2024-00034 BURN PERMIT PROJECT DESCRIPTION: BURN PERMIT ISSUED: 04/23/2024 SITE ADDRESS: 5392 N LAKE CUSHMAN RD HOODSPORT EXPIRES: 05I2312024 PARCEL: 423335102004 APPLICANT: NIGHTINGALE, COREY OWNER: NIGHTINGALE, COREY VERONICA CANTALICE VERONICA CANTALICE HOODSPORT,WA 98548 HOODSPORT,WA 98548 360-999-9276 GENERAL CONTRACTOR'S LICENSE: FIVE GUYS EXCAVATING INC License: BILLMME78265 PO BOX 129 Expires: 04/22/2026 SHELTON,WA 98584 360-432-0971 FEES: Paid Due Burn Permit Fee $175.00 $0.00 Totals : $175.00 $0.00 REQUIRED INSPECTIONS Burn Inspection CONDITIONS * Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator. " 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.) • Access must be passable with 2 wheel drive vehicle. • Permit includes two(2)inspections maximum, additional inspections will require a re-inspection fee. (at current rate). Printed by:Nicole Norris on:05/02/2024 07:44 AM Page 1 of 2 0 Mason County FM MAN= L Mason County - Division of Community Development 615 W. Alder St. I 1 Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BURN PERMIT BRN2024-00034 " "IF BURNING WITHOUT CALLING IN, THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE SUSPENTION OF PERMIT." All materials must originate from the property on which the burning is to occur. Maximum pile size is twenty(20)feet in diameter, a minimum ten (10)feet firebreak must be constructed around each pile. Fire must be completely extinguished within three (3)days after ignition. A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must provide 24 hour fire watch. * The fire must not create a nuisance from smoke, obscure visibility on public roads and highways, or endanger life and property. 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 After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots. " Upon completion of above conditions, applicant must have inspection &approval before ignition. Call (360)427-9670, ext. 352 " 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. APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY. * Valid permit MUST be onsite while burning. If permit is not on site during burning the fire will be extinguished at your cost Fan required. PRIOR TO BURNING A SIGN MUST BE PLACED ON LAKE CUSHMAN RD STATING A"CONTROL BURN IN PROCESS". 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: Date: Printed by:Nicole Norris on:05/02/2024 07:44 AM Page 2 of 2 or EXPIRATION DATE:4*- Permit#: BRN MASON COUNTY BURN PERMIT APPLICATION 615 W Alder$to Shelton,WA 98584 SHELTON 360.427.9670 x352•BELFAIR 360.275.4467 x352 e LLMA 360.482.5269 x352 11 IT FORMATION.FORMATION. CONTRACTOR INFORMATION: Owner 4_Ar Owner Mailing Address 'S;tf tj Cr' e-j4#4 -01 Mailing Address City S city.,_ §tate. Phone Cc Phone,j( Phone-11 it ...... ...........I 0413j,Other Phone-— �T-_Is k. Contractor Reg. Exp. I LiewTitic Holder, ilotc', E-mail address 1ftke,&JA C-.�A f'.)Z-*-k"L 4 E-mail address om% Drivers Lic.# ADt D.0.D.O.B. Drivers Lic.# D.O.B. - TAX PARCEL NUMBER 4 digit numaber) Fire District-10-- SITE ADDRESS(please include street name,number&city)__�112 ltlh-4e e'-sh~^ 120� Directions(to the site)_&�_�l 5440^ *tcz) wet p4kf- //S,-? BURNING IS AUTHORIZED SUBJECT TO THE FOLLOWING CONDITIONS: • Valid peLmit N g,If p ,the fir will!Lc extinguished at JOT he onsiLq while burning grmit is not on si!9 during burning • 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)case 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 attendang at the fire while burning.Must provide 24 hour fire watch. • On Site Water is required for permits between April 15'and Oct. 15". 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 guaffr&&I 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 CALT.360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY. • APPLICANTS MUST CALL 360.539.7610(ORCCA) EACH DAY TO REPORT/REQUEST ANY AIR OUALITV ISSUES ASSOCIATED WITH BURNING. BURNING WITH CALLING IN.THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE SUSPENTION OF PERMIT.'******'t"r******, • After the bum 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 bum site to assure the fire is completely extinguished. The permitted individual is responsible for any rekindling on the firelbum 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 twri-ent rate) • Access must be passable with 2 wheel drive vehicle Date Received: Application continued, please go to next page #Ww Aar 19,2017 Burn Permit 4 'gza"21 fk WC-E"L--A--N'-"'D-'-SITE I N F 0 R M A T 10 N: Parcel within 200'of. Saltwater o Lake o River/CrecklStream o Pond c Wetlands a Seasonal Runof1>_-KrnYes None Slopes or Bluffs> 15%within 50 feet[YesJ No Will timber be cut and sold in parcel preparation? es Does Site require FPA or 6 yr. Moratorium: Yes/Co Is site being converted or replanted: Yes 19 _41 Unknown [Burning is currently NOT allowed inside UGAJ Is site located in an Urban Growth Area(UUA)?.Ves N Summarize proposc(l 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"Bum Pile": • Bum Pile and Feeder Piles • Any existing buildings/structures(ie: Residence,Garage, Storage shed, Driveway,etc.) • Existing standing timber • Any"Critical Areas"such as Steep Slopes, Lake, River/Creek, Wetlands, Seasonal Runoff, Streams,etc - - ------ ------------ ----- ------- -------------- - ---------- - -- --- ---------- I A it 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 =15 r inspection.The person in charge of the fire will be liable for the cost of suppression if the fire gets out orcontrol or if becomes in necessary to ext is fire as the result of an enforcement action, X n 6 SI T E.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 ......................-1-11 1111111-, . V Mason County WA GIS Web Map 47 f Go 141, q O � k O? y 140) a 1 fir kn A 0 3 CY r- Z C C h O L , n„6r.`4? LZ Ws 6GfLlG t�i�y l frr/- �� rG.4/23/2024, 111:52 PM 1:1,529 � 0 0.01 0.03 0.05 mi �-� County Boundary � 0 0.02 0.04 0.08 km ❑ No Filled Site Address (Zoom in to 1:3,000) Sources:Earl,HERE,Garmin,Intermap,increment P Corp.,GEBCO,USGS, FAO, NIPS, NRCAN, GeoBase, IGN, Kadaster NIL, Ordnance Survey, Esri El Tax Parcels (Zoom in to 1 :30,000) Japan,METI,Esri China(Hong Kong),(c)OpenStreetMap contributors,and the GIS User Community Contours 5 ft Mason County WA GIS Web Map Application Mason County disclaims accuracy,reliability,or timeliness of website info,not liable for losses from reliance on it.https://www.masoncountywa.gov/disclaimer.php e t 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 FBRN202'4-00034 BURN PERMIT ESCRIPTION: BURN PERMIT ISSUED: 04/23/2024 ESS: 5392 N LAKE CUSHMAN RD HOODSPORT EXPIRES: 05/23/2024 PARCEL: 423335102004 APPLICANT: NIGHTINGALE, COREY OWNER: NIGHTINGALE, COREY VERONICA CANTALICE VERONICA CANTALICE HOODSPORT,WA 98548 HOODSPORT,WA 98548 360-999-9276 GENERAL CONTRACTOR'S LICENSE: FIVE GUYS EXCAVATING INC License: BILLMME782B5 PO BOX 129 Expires: 04/22/2026 SHELTON,WA 98584 360-432-0971 FEES: Paid Due Burn Permit Fee $175.00 $0.00 Totals : $175.00 $0.00 REQUIRED INSPECTIONS Burn Inspection CONDITIONS * Provide EXCAVATOR/DOZER (with fire extinguisher)on site with qualified operator. " 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.) " Access must be passable with 2 wheel drive vehicle. • Permit includes two(2)inspections maximum, additional inspections will require a re-inspection fee. (at current rate). Printed by:Annie Wilson on:04/23/2024 01:46 PM Page 1 of 2 Mason County Mason County - Division of Community Development 615 W.Alder St. l Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov FBRN202'4-00034 BURN PERMIT ESCRIPTION: BURN PERMIT ISSUED: 04/23/2024 ESS: 5392 N LAKE CUSHMAN RD HOODSPORT EXPIRES: 05/23/2024 PARCEL: 423335102004 APPLICANT: NIGHTINGALE, COREY OWNER: NIGHTINGALE, COREY VERONICA CANTALICE VERONICA CANTALICE HOODSPORT,WA 98548 HOODSPORT,WA 98548 360-999-9276 FEES: Paid Due Burn Permit Fee $175.00 $0.00 Totals : $175.00 $0.00 REQUIRED INSPECTIONS Burn Inspection CONDITIONS * Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator. * 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.) * Access must be passable with 2 wheel drive vehicle. * Permit includes two(2)inspections maximum, additional inspections will require a re-inspection fee. (at current rate). * *IF BURNING WITHOUT CALLING IN, THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE SUSPENTION OF PERMIT.* * All materials must originate from the property on which the burning is to occur. Printed by:Annie Wilson on:04/23/2024 01:31 PM Page 1 of 2 W Mason County BM119M Mason County - Division of Community Development 615 W.Alder St. }1 Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BURN PERMIT BRN2024-00034 * Maximum pile size is twenty(20)feet in diameter, a minimum ten (10)feet firebreak must be constructed around each pile. * Fire must be completely extinguished within three(3)days after ignition. * A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must provide 24 hour fire watch. * The fire must not create a nuisance from smoke, obscure visibility on public roads and highways, or endanger life and property. * 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 * After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots. * Upon completion of above conditions, applicant must have inspection &approval before ignition. Call (360)427-9670, ext. 352 * 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. * APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY. * Valid permit MUST be onsite while burning. If permit is not on site during burning the fire will be extinguished at your cost * Fan required. 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: l e, M I 15 n, Contractor or Authorized Agent: Date: Printed by:Annie Wilson on:04/23/2024 01:31 PM Page 2 of 2