HomeMy WebLinkAboutBLD2024-00303 SFR, Replace Cabin - BLD Application - 3/6/2024 Permit No: L 2Y)2 7'—00303
MASON COUNTY RECEMEM
COMMUNITY DEVELOPMENT
q p 202 W
Permit tusistance Center,Building,Planning i•'�)•;R 0 6 L1iL"T
BUILDING PERMIT APPLICATION615 W. A1er C
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Roger By NAME:TBD v
MAILING ADDRESS:150 N Discovery Drive MAILING ADDRESS:
CITY:Hcodsport STATE:WA ZIP:98548 CITY: STATE: ZIP: town
PHONE#1:5013t9-21WI PHONE: CELL: Z
PHONE#2: EMAIL:
EMAIL:riby t.net L&I REG# EXP. /
PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER❑
NAME Rog-,ft EMAIL IW@wmc t.net
f MAILING ADDRESS 150 N.Discovery Drive CITY Hoodsport STATE WA ZlP 98548
PHONE 503.319-2880 CELL 50a319-2seo --
PARCEL INFORMATION•
PARCEL NUMBER(I2 Digit Ntunber) 4231&W-o0oao ZONING Rural Residential s acres
LEGAL DESCRIPTION(Abbreviated) LAKE CUSHMAN#3 TR 40 S 43/243 FIRE DISTRICT Hoodsport
ISrM ADDRESS 150 N.Discovery Drive CITY Hoodsport
DIRECTIONS TO SITE ADDRESS 101 to 119N.left onto N Mount Church Dr.left onto N Potlatch Dr.right onto Discovery Dr.Destination will be on the right
1
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOB SNOW LOAD: Psf
IS PROPERTY Wr HIN 200 FT OF THE FOLLOWING: (Checkall rhal apply):
SALTWATER❑ LAKE❑+ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑&replace existing
USE OF STRUCTURE(Ruidence,GamgA Conawrcial Bldg,Etc)Residence with attached garage
IS USE: PRIMARY 0 SEASONAL❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 5
HEATED STRUCTURE? YES(Whole Bldg)❑+ YES(Parrisl of Bldg)❑ NO❑
DESCRIBE WORK Build new house with attached garage. Footprint to include existing cabin. Existing cabin will be torn down during construdion.
Ir SQUARE FOOTAGE:(proposed)
I I ST FLOOR 2 66 N.ft. 2ND FLOOR 414 sq.R 3RD FLOOR sq.ft. BASEMENT 689 sq.ft.
DECK 423 sq.ft. COVERED DECK 523 sq.R STORAGE sq.ft. OTHER sq.R
GARAGE 1073 sq.ft. Attached❑+ Detached❑ CARPORT sq.ft Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑+ SEWER❑ / NEW[a EXISTING❑
PLUMBING IN STRUCTURE? YES❑+ NO❑ Ifyes,attach completed Water Adequacy Form
PER]METERNOUNDATION DRAINS PROPOSED? YES❑� NOD EXISTING SQ.FT. sec
EXISTING BEDROOMS 1 PROPOSED BEDROOMS 2 TOTAL BEDROOMS 2
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by
signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection- This pernitlapplication becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
i PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
p COUNTY CODE 14.08.42)
X D 3/6/2024
Signature f OWNER Must JWsigned by the OWNER Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT •ZZ 4
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY Permit No: 0 -Do3a3
..
COMMUNITY DEVELOPMENfECEIVED
Permit Assistance Center, Building,Planning
MAR 0 6 20211
PLUMBING & MECHANICAL PERMIT APPLICATION 615 W. AID
Sbat
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Royer Bly NAME:tbd
MAILING ADDRESS:150 N.Discovery Drive MAILING ADDRESS:
CITY:Hoodsport STATE:wA ZIP:98548 CITY: STATE: ZIP:
11 PHONE:503-319-2880 PHONE: CELL:
2nd PHONE: EMAIL :
EMAIL:ribly@comcast.net L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number):42318-50-00040 Zoning:Rural Residential 5Acres
LEGAL DESCRIPTION(Abbreviated):WE CUSHMAN#3 TR 40 s 431243
SITE ADDRESS:150 N.Discovery Drive CITY:Hoodsport
DIRECTIONS TO SITE ADDRESS:
101 to 119N. left onto N Mount Church Dr. left onto N Potlatch Dr. right onto Discovery Dr. Destination will be on the right
TYPE OF JOB:
NEW ✓0 ADD=ALT=REPAIR=OTHER=USE OF BUILDING
LOCATION OF FIXTURESMVITS—I ST FLOOR=2ND FLOOR=BASEMENT 0 GARAGED✓ OTHERO
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Tyne of Fixture No.of Fixtures Fees Fuel Type:Electric=PG ✓=Natural GasE Ductless=
Toilets 5 Type of Unit No.of Units Fees
Bathroom Sink 8 Furnace
Bath Tubs 1 Heat Pump 2
Showers 4 Spot Vent Fan t0
Water Heater 2 Propane Tank 1
Clothes Washer 2 Gas Outlets 12�!
Kitchen Sinks 2 Wood/Gas/Pellet Stove 2
Dishwasher 2 Kitchen Exhaust Hood 1
Hose bibs 5 Dryer Vent 0
Other Solar Panel 0
Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER acknowledge submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is
by signature below. I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this
permit and to do the work as proposed.I have obtained permission from all the necessary parties, including any easement holder or parties of
interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of
Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void
if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INVALIDATE THE APPLICATION.
X 3/6/2024
Sign ture of 06#er Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT �f✓ y�Z2-Z
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 1BN
s
Name Roger Bly Parcel # 42318-50-00040 BLD#c 24-Q030�3
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface'.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area *All dimensions in feet
Buildings X =
house X = 3184 Measurements for buildings are taken at the
perimeter of the farthest projections(example:
garage X = 1858 eaves/gutters)
X =
Driveways X =
gravel drive X = 3829 Length of drive begins at the right of way
concrete apron X = 818
Parking Areas X =
X = Any paved, gravel or packed area per definition
above table
X =
Patios/Walks X
concrete pads X = 616 Any paved, gravel or packed area per definition
above table
X =
Others X =
X = If the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area (sum of all areas) 10,305
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please read,acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor. I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:3/6/2024
If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign
the information provided on page 2 of 2.
Page 1 of 2
Name Roger Bly Parcel # 42318-50-00040 BLD# a -p0303
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website:
http//www.co.mason.wa—us/code/commissioners/index.htm
Please follow the links to "Title 14,Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document
entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan". This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A _The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples.(Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT. 450
Mail: P 0 Box 1850, Shelton WA 98584
Physical:415 N 6th St, Shelton WA 98584
If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other, parcel. You may also wish to consult with the septic design professional involved with the project. Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical: 426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:3/6/2024
Page 2 of 2
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yA /CPLClMl10N
Z 6535FlJm=218 SF FREE JOIST VENTILATION REO'D�
y 0. ,218 SF(144)=373.52 iM A-62
W
NOTE-756.7.E in(50%)SHALL BE LOCATED ABOVE
3 .EAVES.-
33
0 LO✓yER EAVE VINT=17lBLOCIONG PIECES)x T"� 159J6
9.42 i�(3 x 2'0 HOLES PER BLOCK)--
=IW.22Irt V
UPPER EAVE VENT=17(BLOCKING PIECES) x.
9.42 iK(3 x 70 HOLES PER BLOCK)'
=160.=iR'.
Pad
4
DS MASTER BED
ROOF BELOW
ROOF VENTILATION
ROOF MAIN HOUSE ROOF
3 TOTAL INSULATED AREA 1913.17 SF
M3.1 CALCULATION-
; 1913 SF/300=6.38 SF FREE JOIST VENTILATION RE9D
4 6.38 SF(144)=918.32 iM
NOTE-469.16 i11?(50%)SHALL BE LOCATED ABOVE
EAVES
LOWER EAVE VENT=49(BLOCKING PIECES) x
9.42 in(3 x TO HOLES PER BLOCK)
=461.81 iM 2
UPPER EAVE VENT=49(BLOCKING PIECES)x
9.42 in'(3 x TO HOLES PER BLOCK)
=461.81 iK
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ROOF FRAMING NOTES:
P LANi.ALL ROOF FRAMING TO BE TJI ENGINEER JOISTS AT 24"O.0 TI U.N.O.PROVIDE
APROVED CONNECTORS TYP.AT EACH JOIST TO WALL CONNECTION. rr�^n
' STE 2,2 PLYWD.SHEATHING(LONG DIRECTION)PERPENDICULAR TO JOISTMAFTERS. n
> 3.FASTEN METAL ROOFING WITH GALV.STEEL STAINLESS STEEL OR ZINC FASTENERS,
AS PER METAL ROOFING MANUFACTURERS RECCOM=NDATIONS. y �.
4.PROVIDEAMN.TAIR SPACE BETWEEN INSULATION AND ROOF SHEATHING AT
LOCATION OF
VENT OTH
ERWISE IF SPRAY FOAM INSULATION IS USED,NO VENTING IS
REQUIRED
b 3
5.PROVIDE D,SCREENED VENTED BLOCKING BETWEEN EACH JOISTItAFTER AT TYP.
EAVE LOCATIONS.
6.PROVIDE CONT.SCREENING AT ALL ROOF VENT LOCATIONS.
7.PROVIDE FOR ALL ROOF BEARING DOWN TO FOUNDATION AS REO'D. Ir�'11
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ROOF VENTILATION
ROOF
TOTAL INSULATED AREA=1560.40 SF
CALCULATION- b
1560 SF(300=520 SF FREE JOIST VENTILATION REO'D
5.20 SF(144)=748.99 iK
au
NOTE-374.50 ire(50%)SHALL BE LOCATED ABOVE
EAVES ¢n
� O
LOWER EAVE VENT=40(BLOCKING PIECES) x
9.42 iM(3 x TO HOLES PER BLOCK) ,'-0' U)
=376.99 irA
UPPER EAVE VENT=40(BLOCKING PIECES) x ~
9.42 in(3 zT0 HOLES PER BLOCK) H
=376.99 ir? —b N
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- I DESCRIPTION DATE
DS
DS
3
STANDING SEAM FE METAL ROOFING T CONTINUOUS METAL GUTTERS DRAWN BY:
150 ROOFING FELT OR EOUNALENi ON ON ON 5/4 x 9.25 FASCIA BOARD
i?PLVWOOD OVER PRE-ENG J.FABIAN
PARALLEL TRUSSES @ 24'O.C.—TYP.—
SHEET SCALE:
AS indicated
9 2 211 0 71 3,37-.31 PM
43'-9 LIZ SHEETTTTLE:
ROOF PLAN
A-1.3 _jj
SITE INFO __... _. WPERVIOU�___
SITE ADDRESS ISO N. EXISTING a
DISCOVERY DRIVE CAEN - 655q APPROXIMATE_ -
HOODSPORT,WA W548 DECK - feS 1 '<
SHED 1520 LOCATION — —�
„2RCEE NUMBER, GRAVEL DRIVE- BSX)d g
Y TOTAL - 1,55W
US DESCRIPTION:
IAKE DUSMMAN FJ TR M S AYleJ
20NING: HOUSE - 3.1"Af VI L E-Ao
RURAL RESIDENTIAL SACRES GARAGE - 31
AP N S1B ..1
GRAVEL DRIVE .Jtsqq 1¢ .•• j
RO - Ras
PATIOS.
DECKS AND PANGqN
CONC.PADS - Step
SCOPE OF WORK EX.SHED 162.1
DEMO EXISTING CABIN.BUILD TOTAL - 10.4579
2761 SF WOOD FRAMED HOUSE PROPERTY _ CSE,,,EE Setbacks
ON POURED CONCRETE EH Setbacks ♦
FOUNDATION,BUILD IW2 SF AREA IS�tJeq 0 • Y
ATTACHED GARAGE. rnIMPRV.% - SS% wc.n... A.)Drainfield)Reserve requires 10'setback from feefing/foundabons � Y�
_ If I Septic tank(s)requires 5'sefback from all looting/loundaoons E
-- C.)No foundation/Perimeter Drams within 901t,downgradient of
Drambeld/Reserve area S bxO �g
D.)No Cut Bank(s)(greater than SR and over 45 degrees)within nih� �
50tt down gradient of Dralnfield/Reserve area gY
E
EXISTINGGRAVA EH APPROVED
' a wmme wwA xrcranrP NWIKWWY
GRAVEL WALKWAY
o d / / TOTIEINO `L
Rhonda Thompson 03/28/2024
rwrteoe mcecrircKA mr /YV' J/\ ry ryFJ �,•/ AF-,'YATKWAY
T / `
vJp S ^
yy 4P4' ; rL= ? S PROPANE ON-0EMANO
1 rp°el.xr mcearwrtea PrAarww C#'/ �j�((C / 4 b 7/GE/ /TOR/ ` Q
M1 ATb /
/ MINI SPLIT/ T
4'�j -bl � A, � Ixn000R GNI
PROPOSED GRAVEL e
I;OIALI011 H'�•I ( R EDRIVE(SHADED)
LIVE 'b•• /ss _ yyb I ^n
EXISTING CABIN ROOF IgTTUB N 2N W
tary,<"wwwcwa.anararwLra,<",;rrn^o�'rrPaRcmw^e'ryureu r'a.F cn°°arrr.wRwn eau um...rcco sP[seeoU.ucnwyrrx,v rcrtrr
HEDOVERHANG(DAS
GREEN LINE)/ /ROISE D DECK
(SHADED)
b: /
,EXISTING DRIVE :-r0 bab J
TRENCH (RED DISHED LINES)Alf
P Sd D]
wn a erM r ermA1K ���>� / $qp°�• Z >
T EXIBTINGDECKI j" Sheet List lL-
STAIRS(DIAGONAL UP O
SHADING)
a urumev r r % CONL•APRON SMM NIrn10Fr SREPIAN SIIM Nr1Iro Z �Q
K[A rMla ruPwgrorulcvr° c .I
rK cn iwnw rewr rnrul warOKncFWe
N ROPOBED A4,1 :MAN FLOOR PLAN UW N
Acwna.c.°rwe uwrrcveerccawwmvr° rEKI M7 OL BA6EMENTlLOFT � Y�
rRUNrMwNaeMuoaenm Nonarm Nn wnurt R�PNROROUD 0
S \i I+lA/l __ W
�
vrcea. 7_ _ gOOF PIAN � b�i
rrt ew�wre�wnwUFnlAu iaeUanwnrrax :. b $ 1' I - PROPOSED DRAM R',Lp AR _ ELEVATION—NM 14 Op$O
a . e 1 rX.aKua �, I 1'T I IELD RED 1\ A-2.7 ._....... ELEVATIONB-EAA a =v
MAN HOUSE SECTIONS
"NS
Is
vne
rK e°xrMcrogewu vUFCAU A°onpKK egoPN
eewurKKre rrwmPAeuorwwic°wssnrwKc h ` AJ2 GAMGE SECTIO
633 M6TR/OL BASE
rco5xceeEn I I __b —. — .... xrc�rn.
relalrcw�om _ _ � b �}b b b �b� >;�PDBED b �... .FECUNDATION DETALB
PROPOSED I rd �' �+ N yy _DRAIN FIELD Q 6 6 '7 ROOF DETAS.S
AL CONSTRUCTION DRAWINGS AND $ p 'Ij LOWER TE
25Y- p d b Adz STAIR AND DECK rm
PROPOSED HCUSErGARAGE PLACEMENT If SEPTIC TANKS \ 1 1 25Y• DETAILS
IN THIS SET ARE DESIGf�O TO THE \I I 1 4 1 pppR pp UMT ��� T.• �1 p ,y A{2 BWINDOW DEiAS3
�r51'-Ni/ / �'C
CLIENTS REOUEST.AL PROPERTY LINES. - --"—— AS IFIdI Wd
BOUNDARIES.AND SETBACKS SHALL BE _
CONFIRMED BY A LICENSED LAND 2'min
3 SURVEYOR THE•COMMON LINE'ON eleTemM
THESE DRAWINGS WERE PROVIDED BY r
THE CLIENT.AND We DESIGNS,LLC. SITE SCALE: r, 1
tf MAKES NO REPRESENTATION OR O --WARRANTY AS AS TO THE ACCURACY OR 1�e 30�-X
PLACEMENT OF THE COMMON LINE. 0 )5' 15 le 6D 120 A-0.1
MASON COUNTY Mason County Permit Center Use`.
COMMUNITY SERVICES �
ADv �D - 0005
Building,Planning,Environmental Health,Communityl,lealth
615 W.Alder St.—Bldg.8,Shelton,Wa 98584 Date ROM 3 LTV
Phone:(360)427-9670 ext.352♦Fax:(360)427-7798 -
Fee: $130.00
Request for Administrative Variance for
Reduction in the Required Setbacks
For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the furthest projection of the structure,
including roof eaves and gutters.
Applicant/Owners: P-06 F 4 - g L y
Mailing Address: f E
City: /'e,,)0b 5; PO f, -7 State: w Zip:
Telephone: 5-0 3 ' T/ 9 • 2 W FO
Email: f—__T(? L-f ® <zo tj C,4j-7, ,j E 7
If this reduction is tied to a building permit,please give permit case number.
BLD Q") - Qd 5dJ
Parcel Number(s): 09— SC> - Ooo �/� Zoning s
Site Address: a N t f Goy/ S/z y Of_-I V F f1? v(9SPo/L-7 , ,,✓A c'k S-y17
Requested setback variance:
ft. ❑ Front ❑ Rear Side
ft ❑ Front ❑ Rear Side
ft. ❑ Front ❑ Rear ❑ Side
ft ❑ Front ❑ Rear ❑ Side
Front Setbacks—From access easements and road right of ways. Minimum 10 feet.
Rear Setbacks—From the rear property line. Minimum 10 feet.
Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or easements, and set backs to all
property lines and existing buildings, slopes, surface water,wetlands, critical areas, septic,well and
driveway. Show all proposed new development.
S
FRONT AND OR REAR YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
1) One of the following exists on the lot(check all that apply):
❑ a) steep slopes,wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-fourth acre;
❑ e) existing improvements of buildings, septic systems, and well areas.
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
2) One of the following exists on the lot(check all that apply):
0 a) steep slopes,wetlands,or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
d) lot size of no more than one-half acre;
?0 `r Z � e) existing improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
C.,177 51-Z-C- -�- S IAA G w 7A
�CtS� N 579-,A c-7crP� .
Owner/Agent(please indicate) �O 2
Sigia,ture Date
Official Use Only
Approved by:. Date L -mil Ij
Denied by Date
Reason for denial: