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Home My WebLink AboutMEP2021-00013 - MEP Permit / Conditions - 11/12/2021 Mason County Planning Division of Community Development `r 615 W. Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us F 1-00013 MASON ENVIRONMENTAL PERMIT DESCRIPTION: MEP FOR 24" CULVERT CROSSING FOR A ISSUED: 11/12/2021 ON AN NS STREAM ESS: UNKNOWN MASON COUNTY EXPIRES: 11/12/2023 PARCEL: 122167590032 APPLICANT: MUSSELMAN DAVID A& DEBORAH C OWNER: MUSSELMAN DAVID A&DEBORAH C 990 KAZAC PL SE 990 KAZAC PL SE PORT ORCHARD,WA 98366 PORT ORCHARD, WA98366 360.932.1619 OWNER'S REP: ARCTOS AERIAL 680 E PHILURA LN SHELTON,WA 98584 360.229.3118 FEES: Paid Due Mason Environmental Permit $115.00 $0.00 Habitat Management Plan $300.00 $0.00 Review Fee Totals : $415.00 $0.00 CONDITIONS • Proponent shall obtain all necessary Federal and State permits prior to the commencement of any work. • Work must be done in the dry to help prevent disturbance of unstable soil layers and uncontrollable mass wasting. • Approved per dimensions and setbacks on submitted site plan. • Archaeological or historical resources, such as ruins, sites, buildings, artifacts, fossils, or other objects of antiquity that may have significance from an historical or scientific standpoint, which may be encountered by the developer/contractor, shall not be further disturbed. If the developer/contractor encounters any such artifacts, he/she shall immediately stop work and notify Mason County and the Washington State Department of Archaeology and Historic Preservation. Failure to do so may result in civil penalties. Printed by:Ariane Paysse on:11/12/2021 01:52 PM Page 1 of 2 Mason County �z Planning Division of Community Development ' 615 W. Alder St. Bldg. 8 tea' Shelton, WA 98584 Q7.H.L1V3��i 360-427-9670 ext 352 www.co.masonma.us MASON ENVIRONMENTAL PERMITMEP2021-00013 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 provisio of ny other state/local law regulating construction or the performance of construction. Issued By: t Contractor or Authorize Agent: Date: Printed by:Ariane Paysse on:11/12/2021 01:52 PM Page 2 of 2 j ` Mason County Permit Center Use: MASON COUNTY COMMUNITY SERVICES MEP ZGZeI - C13 Building,Planning,Environmental Health,Community Health Date Rcvd Q 615 W.Alder St.—Bldg.8,Shelton,Wa 98584 Phone:(360)427-9670 ext.352 ♦ Fax:(360)427-7798 MASON ENVIRONMENTAL PERMIT:S 115 REC&1 V ❑ MASON ENVIRONMENTAL PERMIT WITH HABITAT MANAGEMENT PLAN:S1500 C D ❑ CONDITIONAL USE: S2000 JUL Q 8 2021 61 Mason County Resource Ordinance(Chapter 8.52 MCC) Jr VV A/der stree ENVIRONMENTAL PERMIT APPLICATION t 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 PT A MNWG Name: Deborah Musselman Ll�l�IJL�I�jv Mailing Address:990 Kazac PL SE, Port Orchard, WA 98366 Work Phone: Email Address: Home/Cell Phone: Fax#: If an agent is acting for the property owner during the permit process, complete#2. 2. AUTHORIZED AGENT Name: Rob Nagel -Arctos Aerial Mailing Address:PO Box 2466, Shelton, WA 98584 Work Phone:(360) 229-3118 Email Address:aretosaerial@gmail.com Home/Cell Phone: Fax # 3. PROJECT SITE Site Address: XXX State Route 302 Parcel#: 12216 - 75 - 90032 Legal Description: Directions to Site: From Allyn, drive north on highway 3, turn right on E North Bay Rd (St Route 302). Access road is on the left just after 3250 E State Route 302. 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. Rev.March 1,2018 v a 4. State which section requires pcnmit: ❑ Long Term Commercial Forest,Chapter 8.52.060 ❑ Frequently Flooded Areas,Chapter 8.52.130 ❑ Mineral Resource Lands,Chapter 8.52.090 ❑ Geologically Hazardous Areas,Chapter 8.52.140 ❑ Critical Aquifer Recharge Areas,Chapter 8.52.120 ❑ Seismic Hazard Areas,Chapter 8.52.150 ❑ Erosion Hazard Area,Chapter 8.52.160 19 Fish&Wildlife Habitat Conservation Areas,Chapter ❑ In-Holding Lands,Chapter 8.52.070 8.52.170 ❑ Wetlands,Chapter 8.52.1 10 5. Identify current use of the property with existing improvements: Undeveloped lot 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): Proposed 24" culvert crossing for a driveway on an Ns stream. 7. Describe why the action requiring this permit cannot be avoided. This is the only access option for a proposed SFR. 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. Connected to Septic Connected to Community Septic 11. Identify existing water supply (circle one): Public Water Supply Well IL. T e of Job(circle one): ttNew Add Alteration Repair Demolition Other: Print Name Signature Date Rev.March 1, 2018