HomeMy WebLinkAboutBLD2023-01392 - BLD CD Environmental Health Review - 11/16/2023 • P��RNNo:b�oaoa3-o139
MASON COUNTY RECEIVED
COMMUNITY DEVELOPMENT
p¢hR�smn¢eLhWh Epildm,,Pl.hnine NUV is 2023ENVIRONMENTAL
BUILDING PERMITA TI
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 6B92lvo 1>T9-�Sold NAME: f/i 1-Wr AIM&s
MAILING ADDRESS MAILING ADDRESS:3Elp 5.
CITY:STXI"7 N STATE: W4 ZIP: a CITY: , 7 S P STATE: u/A ZIP: S / C5L
PHONE41: a;IOJ *05 tlq7,f PHONE: 3/e0.g r•a/32ELL: �rw gai-) -t32 ;Uq qe2 -J'ZZ7
PHONE82: EMAIL: c HA d Ina 5 ax,
EMAIL: iO ! VX• /K L&I REG N EXP.
PRIMARY CONTACT: /� OWNER CONTRACTOR❑ OTHER[]
NAM Lnnzejrgq AI EMAIL T irt/R //'/i DO,L //TICS
MAILINGADDRESS '/0 C� .ilea✓thaw /Sy- "I CITY �[�STATE�ZIP -1
PHONE Ti W4)_F `Sr 7�- CENT.
PARCEL INFORMATION: j/pF SP-143x .ff5 1 (?49
O
PARCELNUMBER(12Dieit NuabmO 27l 13. 76 ' yn032. / ZONING {C n J 9
LEGALDESCFUFTJON(Abbre iam)'TK d-/! Ar5.5.4v01 U�3T6FIRE DISTRICT T
SITEADDRESS 9U C SA)U LUwcI r LAF., CITY SMELL . �'
DIRECTIONSTOSITEADDRESS PL i?ie'cS 'J Td PN�It.lFS L-K R!] T7 G o
lE
IST PROD WI'I'BA`8 FTOFSLOPE(S)GREATEATBAN14h: YESK NOA SNOWLOAD:_y,f 5
IS PROPERTY WIIHDl200 FT OFTRE FOLLOWING: l(NNNlrbrgpy). A/e
SALTWATER❑ LAKE❑ RIVER/C [] POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAM❑ Al AV-
TYPEOFWORK: NEW)j ADDITION❑ ALTE/�RATION❑ REPA�I/R❑ OTHER ❑
USEOFSTRUCNREIRndore.Gn ,Cwm BU9,,F ) ke>lVCNCE o)I A-rTACil HIS &YR/Y.'�/!
IS USE: PIUNIARY). SEASONAL❑ NUMBEROFBEDROOMS__;_7 NUMBEROFHATHROOM5__2,_
HEATED STRUCTURE? YES(wain NUJ& NO❑
DESC E WORK N�uJ µe L:NE 1&AIF EL&W ZZ06
SQUARE FOOTAGE:Brame
IET FLOOR )0 sq.R 2ND FLOOR��sq.ft 3RD F]AOR vI.R BASEF/E�N�I�(/ N.ft
D OS K. COV
ERED aD DELCpKeRsq.ft. STORAGE
CARPORT�sq.ft An 0 Detached[]
MANUFACTURED HOME INFORMATION: 4 COPIES OF THE FLOOR PLAN REQUIRED'
N ��� )))
MAKE # MODEL YEAR N/R- LENGTH a/a
wmrx BIDROOMS Lv .V BATHS SERIAL NUMBER N�A•
ENVIRONMENTAL HEALTH:
//��� SEWAGE/SEWIA SOImCE: SEPTIC`0 SEWER(] I NEW' EXISTINO❑
1 PLUMBNG IN STRUC111RE4 YES //- NO❑ {lye.,an mryitefed Winer Adeq Fan
PERDMETERhOUNDATION DRAINS PROPOSED? YE NO[]NO[) EXISTING SQ.FT. 'C(
MSTING BEDROOMS PROPOSED
BEDROOMS—l—LTOTAL BEDROOMS�`�
OVINERbeM1l aNBIauhni&MMNe¢Pneleimadaa vile msu a54p xoh orha or pemYl remtlm.OckvMea,JeneM W haw iity
syreNre Eelar.laWm mat em tM doer ane NMneetlseM inn entilkah reLalw ink Terme eMto au Ne wkasheo—er.lnaw
oEulnea pefmission hcm all Ce mmssery paNee,in 1gry yry e9semem Meera palls of lMxst reBarayg ink ggen. lne miner or legal
repressntetire,r�2u k mM me Inlmnalpn proNtl¢a i aSnale aN prYa6 amployep of MaSeM1 LwMy eMas b VK eaow aescnbae prcpMy
ana abuClV¢Is)Ip Rria+v ana mspecaon. inl5 peimNeRVYJWn Cewnl¢b fuII85Fe HxOrk Or eupgM1ietl MM1sput90n k nd MnrnerV2tlwMInIW
aays or6rvnstruNm xwk i suepmtlatl Me µn'M M t8U aays.
PROOF OF CONTINUATION OF W K ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT CATION OF I AYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(WSON
^. COUNTY CODE 14.08,42)
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BgneWre of uat Ee e" n Me DWNER pale
kDUA�7�ENTAL
APPROVED DATE DENIED DATE TAGS?IOTE&CONDTFIONS
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