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Home My WebLink AboutBRN2012-00013 - BRN Permit - 4/24/2012 Inspection Line (360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, WA 98584 too BURN PERMIT BRN2012-00013 OWNER: LDS CHURCH RECEIVED: 4/24/2012 CONTRACTOR: LICENSE: EXP: ISSUED: 4/24/2012 SITE ADDRESS: EXPIRES: PARCEL NUMBER: 122083290001 LEGAL DESCRIPTION: LOT: 1 OF SP#661 PTN NW SW E OF R/W` PROJECT DESCRIPTION: DIRECTIONS TO SITE: LAND CLEARING FIRE- PURPOSE OF COMMUNITY GARDEN AT THE INTERSECTION OF HWY 3 AND 302 (VICTOR CUT OFF RD) BURN TYPE: FEES Land Clearing Type By Date Amount Receipt Burn Permit T1N 4/24/2012 $160.50 S1201200000000000584 Total $160.50 BRN2012-00013 Please refer to the following pages for conditions of this permit. Page 1 of 4 CASE NOTES FOR BRN2012-00013 CONDITIONS FOR BRN2012-00013 1) Permit includes two(2) inspections maximum, additional inspections will require a$73.00 re-inspection fee. x A v'j 2) Applicants must call 360.427.7761, EACH day to report burning activity. Last 3 numbers of permit required at time of call in. X &VI/ 3) Applicants must call 360.586.1044 (ORCCA) EACH day to report/request any air quality issues associated with burning. X A W 4) Xalid permit must be on-site while burning. 5) 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. X AW 6) The following materials may 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 normally releases toxic emissions, dense smoke or obnoxious odors when burned. X A \„) 7) All material must originate from the property on whichthe burning is to occur. X AW 8) The fire must not create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property. X 1\\A/ 9) The maximum pile size is twenty(20) feet in diameter, with a minimum ten (10) feet firebreak around each pile. x A\AJ 10) Each pile must be at least one hundred (100) feet from any structure and atleast fifty(50)feet from standing timber. x A VJ BRN2012-00013 Please refer to the following pages for conditions of this permit. Page 2 of 4 11) Do not burn if wind is blowing more than seven (7) MPH. X ,A \,J 12) Do not burn if wind is blowing from XX direction. (This will be indicated on the posted permit at the time of site inspection.) x A V\.! 13) A minimum of one qualified operator is required to be in attendance at the fire while burning. A burn site/fire shall never be left unattended. MUST PROVIDE 24 HOUR FIRE WATCH. x A 14) On Site Water is required between April 15th and Oct. 15th. The pump truck or trailer must have 300 gallons of water loaded and 200 ft of hose. (Pump must be capable of pumping 20 gallons per minute through a one-inch (diameter) 50-foot hose.) X A\rJ 15) It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished. Permitted individual is responsible for rekindling on the fire/burn site.( 16) Provide excavator/dozer with a fire extinguisher at the site with a qualified operator. X_ A Val 17) Provide a 24-hour fire watch. X A V\I 18) 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 necessary to extinguish the fire as the result of an enforcement action. X AV\J 19) Access mutt be passable with 2 wheel drive vehicle. X HW 20) Fire must be completely extinguished within three (3) days after ignition. x Aw 21) After the burn is complete, YOU MUST touch by hand, the earth to make sure the fire has not burned down into the earth. X 22) Fan is required. X BRN2012-00013 Please refer to the following pages for conditions of this permit. Page 3 of 4 This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. OWNER OR AGENT: 1W,yv-c DATE: 4i�yAl�— BRN2012-00013 Please refer to the following pages for conditions of this permit. Page 4 of 4 1 z CONCRETE MECHANICAL MANUFACTURED HOME p ._ _ Cl) oFootings/Setbacks GatePiping By Ribbons 0 0o Interior Date By Interior-Date By Date By C o Exterior Date By Exterior-Date B Set-up n w Point Load/Isolated Footings INSULATION Date By 2 BG f SLAB INSULATION --� _- Date By Data By FIRE DEPARTMENT Foundation Walls Floors Date By Date By Data By DECKS FRAMING walls Date By Date By Data By PROPANE TANKS PLUMBING vault Date By Date By OTHER Groundwork Attic Date By Type DateB y Date By D.W.v DRYWALL Type- Date Brace Wall Date By ca Oate By Date 8y FINAL INSPECTION z m m y Water Line Fire SeparationCD N m Date By Date By Date By O N o Pass or Request Inspect. c Type of Insp. Fail Date Date Done By CommentsCD o o w to v Io y -r. O 0 O 7 a o' Cn N O 3 tn CD (D 3 N (O M 0 1 , . MASON COUNTY BURN PERMIT APPLICATION_I,, 426 W CEDAR ST. • PO BOX 186 • SHELTON WA 98584 SHELTON 360.427.9670 • BELFAIR 360.275.4467 • ELMA 360.482.5269 APPLICANT INFORMATION: CONTRACTOR INFORMATION: Owner _ 7S C 1, W;,rw 6g;_i1 Owner .S-Fav\ Pa)n e r- C.on sf f V e_I`;on Mailing Address 'D 13ox '2 r2 Mailing Address City t3 ejcn;,r State WJZip q SS? City State Zip Phone(31002-75- 156 4PT►one 4�3(A�)2-77--2150 Phone Other Phone Lien/Title Holder Contractor Reg. # Exp. E-mail address CA w',n a @�notmc►'j 1, c 6 M E-mail address Drivers Lic.# W DOB 2f2g/`75 Drivers Lic. # D.O.B. TAX PARCEL NUMBER Sec. Twn. Rng. Fire District SITE ADDRESS(please include street name,number&city Directions to the site at 4-.ke -3 L_L..t-CX-( R-1.) Parcel within 200'of. Saltwater o Lake❑ River/Creek o Pond❑ Wetland❑ Seasonal Runoff❑ Stream❑ Slopes or Bluffs> 15% Yes N Will timber be cut and sold in parcel preparation?Yes/ o Does Site require FPA or 6 yr. Moratorium Yes o Is site being converted or replante Yes o Reason For land Clearing tb Gr -e e oN Co rn rel cn t Is this application the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No Burning is authorized subject to the following conditions: • Valid permit must be onsite while 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 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 is 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 15`h and Oct. 151h. 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 360.427.7761, EACH day to report burning activity. Last 3 numbers of permit required at time of call in. • Applicants must call 360.586.1044(ORCCA)EACH day to report/request any air quality issues associated with burning. • 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 OWNER/CONTRACTOR:Acknowledges submission of inaccurate information may result in a stop SITE SKETCH/NOTES work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owner's legal representative,or contractor. I further declare that I am entitled to receive this pen-nit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed.The owner or agent on owners behalf,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 APPROVED DENIED becomes necessary to extinguish the fire as the result of an enforcement action. X �✓�.�� Date H/,ZL4/2 o 1 Z INTIALS Owner/Owners Represen ative/Contractor(indicate which one) DATE