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Home My WebLink AboutRLC93-00273 - RLC Inspections - 11/15/1993 MASON COUNTY 1(- K-Gl 3 DEPARTMENT OF COMMUNITY DEVELOPMENT RESOURCE LANDS AND CRITICAL AREAS CHECKLIST 33 t I►e following checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Site valuation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Lon' d egregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by ,gulations under the Mason County Interim Resource Ordinance (77-93)*. This checklist is an important portunity for identifying earlyin tl)epermit process whether there willbe any environmental regulations affecting �e proposed development. wner_ _C/1u� c n f t/ e JVV z 2%7f- e Phone ite Address City SP ��o-�� Zip 9 g5�y wner Address 56--r2l r- City State Zip ax Parcel No. (Confirm with Assessors Office) 2G )1L - Z1 - `0 Legal Description_ oject Description 1J Wes- - W, 7 irections to site (Please attach map) ease provide or attach a vicinity map which includes cross streets, major roads, creeks, etc. {��/1 t 1 1 � rl _ 3 S� lC Cc- �° Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas et.t and resource lands are available for review at Mason County Department of Community Development, Planning Only Department. Do any of the following exist on this property or within 200 feet of thi property? t Yes No ❑ Q' 1. Saltwater shoreline or a lake 20 acres or larger? ❑ [J— 2. Rivers, streams, or creeks with year-round flow? ❑ ED— 3. Rivers, streams or creeks with intermittent flow but are a clearly defined channel? ❑ Er 4. Lakes or ponds less than 20 acres in size?M ❑ D— 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.) " ❑ [ 6. Slopes greate than 150o (8.5 degrees)? (See the County Lan slide and Erosion Hazard Maps for guidance.) 1 D�0#1-VK 0J "W1 ❑ P 7. Floodplains? (See Co ity Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) ❑ E!r 8. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any of the following programs: t Yee No ❑ El- 1. Agricultural Open Space Taxation Program, RCW 84.33 ❑ [!1- 2. Open Space.Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest, RCW 84.34 Cc!pios are available at Mason County Department of Community Development for $5.00 each. SITE PLAN LEASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE: Location &dimensions of existing &proposed property boundaries. ► Approximate slope of land (grade & direction), topography. Identify legal access Including, width of all road right-of-ways &easements. ► Location of significant natural features (water bodies, rivers). Locate all existing &proposed structures,dralnfields, wells & driveways. ► Project description kale 1"— �S 5 North Arrow —17 h n Q � 0 U 7 - �^ o state that I have answered the above truthfully to the best of my knowledge. 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'>�:$:'�' :.�. 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 port of the permit opplicotion.