HomeMy WebLinkAboutSPI2024-00043 - SPI Application - 4/22/2024 MASON COUNTY SPIN-- -
COMMUNITY SERVICES
Building,Planning Environmental Health,Community Health PLANNER r
615 W.Alder St.—Bldg.8,Shelton,WA 98584 (,t VI vl
Phone:(360)427-9670 ext.352♦Fax:(360)427-7798
PLEASE PRINT $300.00 FEE REQUIRED
PLANNING DEPT. PRE-INSPECTION APPLICATION
Note:Pre-inspection does not survey lot lines and can only provide very general septic and water adequacy information.
1. Owner: Na w' Arxle !�Or1 Applicant:
Site Address: C-,q I E. PNWV1 n (-.ak l.-o:�p M Applicant Address:
Owner Address: P0 L3t7j( $f egQ�A City: St Zip
City: St Q-A7 Zip q�3ZD Phone:(_) day
Phone:( `23`—'rZ. CIA 15 day Email Address: 41 oon1 (ri N&o,•L LoJgn•-aA .C&"
Phone:(_ evening cJ
Legal Description:
2. Parcel No. '2-10 0 n 0 00 CJ 3
Parcel No. - -
3. Purpose of Pre-Inspection: A eo ey&A w-1 bi(i IM_, 10 LAI; (d t vt a o `a to S'
4. Use of building: yG_c tn+ lu"
a cwvss +1�- sfire<�
5. Do any of the following exist on or adjacent to property?: slope( ) saltwater( ) lake(V-) river( )
pond( ) wetland( ) seasonal runoff( ) other( ) stream( ) seasonal creek( )
Directions to Site: VAW 40 VV:,I I ns lLlr.-?— L,000
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: Date:
W 22�2►�
If you would like to be on site during inspection,please check here:
Return application to: Mason County Community Services,Planning Division
615 W.Alder Street
Shelton,WA 98584
(360)427-9670 ext.352
Please include a$300.00 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:_ j 01 150y1_ Date:
MORE ON BACK SIDE
Rev. April 2021
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 TO THE APPLICANT.
U—
Departmental Review
(For Office Use Only)
Planning Department Findings:
Mason County WA GIS Web Map
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1 670 E PHILLIPS LAKE LOOP RD
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Site Address (Zoom in to 1:3,000)
Sources:Esri,HERE,Gannin,Intennap,increment P Corp.,GEBCO,USGS,
FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri
�I Japan,METI,Esri China(Hong Kong),(c)OpenStreetMap contributors,and
Tax Parcels (Zoom in to 1:30 000)
the GIS User Community
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