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HomeMy WebLinkAboutRLC93-0437 - RLC Inspections - 12/3/1993 Date Recei led: O MASON COUNTY • ` '� DEPAR MENT OF COMMUNITY DEVELOPMENT RESOURCE LANDS AND CRITICAL AREAS CHECKLISTS L The following checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Site Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Land Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by regulations under the Mason County Interim Resource Ordinance (77-93)*• This checklist is an important opportunity for identifying early in the permit process whether there will be any environmental regulations affecting the proposed development. Owner STcge., 0e121, Phone #(UG ) 705-734'7 Site Address \M!n-v we5� City 6t-e I1-a%-\ Zip Owner Address e Q . &,oX 4'T3Z19 City 0Ivmj2ic3, StateWRZip 9SSO'4 _ Tax Parcel No. (Confirm with Assessors Office) 4Zo0 Z - 3ZCb - 0 EJ 1 © Legal Description_, A j3Qr-T on of -the_ l JW VA of SW VA �5�-bg n 2 1 Zo N � R 4 W Project Description C-o�riStcuc-t (N, \oc.o-\ hoc c,wav rna,�nter>ar�ce �� up 1-0 ve_hir_le.s (3,Aa a� 8460 SF bu,`1a � Directions to site (Please attach map) GO w&sT 07 ajP s o,n S i, /0 Z fi'007 SK 1011 , GO sovrh 400 Wa.V Wesr g2CLS r C3c�s,`nes5 Par Ro ark - 'Si-re- i 5 on r i!;&v bet w ee. ' c> c fsc c �Alc 4 'SrfxTe ki--ro i Site'. Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc. to Z Tnes a Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas Official and resource lands are available for review at Mason County Department of Community Development, Planning Use Only Department. Do any of the following exist on this property or within 200 feet of this property? Coun 'Yes No ❑ N 1. Saltwater shoreline or a lake 20 acres or larger? ❑ 2. Rivers, streams, or creeks with year-round flow? ❑ ® 3. Rivers, streams or creeks with intermittent flow but are within a clearly defined channel? ❑ El 4. Lakes or ponds less than 20 acres in size? WING ❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See County Maps for guidance.) V`j�, ❑/ ❑ E3 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for guidance.) 0� ❑ [Z 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) � ­' '7A)h Q/ ❑ ® 8. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) V A ' You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any of the following programs: uCoun Yes No D N 1. Agricultural Open Space Taxation Program, RCW 84.33 zr� ❑ M 2. Open Space Timber Taxation Program, RCW 84.33, or Designs ed Forest or Classified Forest, RCW 84.34 PJOV4k- .-� I Copies are available at Mason County Department of Community Development for $5.00 each. r RESOURCE LANDS & CRITICAL AREAS / SITE PLAN PLEAS SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE. . L.o,-ation &dimensions of existing & proposed property boundaries. ► Approximate slope of land (grade & direction), topography. . Idontify legal access including, width of all road right-of-ways&easements. ► Location of significant natural features(water bodies, rivers). . Locate all existing & proposed structures,drainfields, wells & driveways. ► Project description Scale 1" = North Arrow 6 I �Jee. o`�-T�.c.�1 ec� Plans state that I have answered he above truthfully to the best of my knowledge. Applicant/Owner 1213/q3 Date FOR OFFICIAL USE ONLY Adjacent property. 4ILo �z �Z:Q-lam ay`� ov- Using County Resource Land Maps, this property is designated as: 1 Long-term. Commercial Forest 4. Shoreline Master Program k: 2. Inholding Land _..... .. ...5, Does not apply. 3. Mineral Resource Land ate DCD There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Mason County Treasurer. When completed, this form becomes part of the permit application. 4 RoseWater Engineering, Inc. LIEUTEM ' Civil Consulting 1932 1st Avenue, Suite 711 - Seattle, Washington 98101 DATE JOB NO. I Z � 9 3 � Z-� 17• � 3 � (206) 441-9385 FAX 448-6922 ATTENTION To 1Vl�->,�-=�,,� C.oc�t�t-v �1ann�rz� OerJT RE `T- .S WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. 1 DESCRIPTION ►Z 2- S U r L tv Lanj t;> a ii Cr/',t/c cd )Yc. ck C bE-C_k I,I .T q3 1 Chem-_ kr 0 THESE ARE TRANSMITTED as checked below: For approval ❑ Approved as submitted ❑ Resubmit copies for approval as noted Submit-copies for distribution r your use ❑ Approved ❑ ❑ Fo yo > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS _TTkt �ee ;"Ic SVSt�m c9��o�i c�t�O0 IS beincg �U�n11t1��/ 7�C1�y � tt � utpu have_ U auEst a COPY TO ��' O/ 5 ^ W O1 � �itQcfivi�. 40%Pre-Consumer Content•10"/o Post-consumer content O� l L SIGNED: _ Paooucrlao Inc,Groton,Maa own If enclosures are not as noted, kindly notify u at once. 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