HomeMy WebLinkAboutSPI2010-00064 - SPI Application - 8/26/2010 �,
(� l v(�K - MASON COUNTY
PLANNING DEPT. PRE-INSPECTION APPLICATION
PLEASE PRINT $255.00 Fee Required g
1. Owner: Applicant: -:S_areA SOL111��✓�
Site Addressd I I I I S.al Q 4_ 302- Applicant Address: 1 Z 70(, :
Owner Address: City:' I Qe_e,,ytA St a. Zip `fi $yq&
City: A j�u� St Zip P► � Q^ - -e gq/a day
Phone:(_ day i
Phone:) evening Planner:
Email Address: SMP A&gb omp. Plan T e of Use
Water Body
2. Parcel No. LZ� 7 - - � L
Parcel No.
Legal Description:
3. Purpose of Pre-inspection �n+ �a Y"
4. Use of building: &ya— C�_L V
5. Do any of the following exist on or adjacent to property?: slope ) saltwater lake ) river
pond( ) wetland( ) seasonal runoff( ) other( ) stream( ) seasonal creek( )
Directions to Site: �b 'l�D✓ c G ;
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If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies.in the original
application. Pre-inspection reports remain valid only until development changes occur in the vicinity which affect the lot
evaluated in this inspection, or the laws regulating development of the site change after the time of inspection.
Applicant Signature:_/Q 14� Date: '3-Zy
If you would like to be on site during inspection,please check here,4
Return application to: Department of Community Development, Planning Division
P.O. Box 186
Shelton, WA 98584
(360)427-9670
Please include a$255.00 check or money order payable to Mason County Treasurer
When completed,this form becomes part of the parcel file.
FOR OFFICE USE ONLY: Accepted by: �P,� Date' l
MORE ON BACK SIDE
I:\PLANNING\PACTRE-INSPECTION Revised: 12R6108
Please illustrate below the proposed building site in relation to critical areas (slopes, streams, lakes, wetlands, etc.)
existing improvements, as well as property lines. APPLICATIONS SUBMITTED WITHOUT ADEQUATE
ILUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED M THE APPLICANT.
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Departmental Review
(For Office Use Only)
Plannin Departmen Findings:
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