HomeMy WebLinkAboutRLC Application - 4/20/1995 Date Received:
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
RESOURCE LANDS AND CRITICAL AREAS CHECKLIST
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 (77-93J*. 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 all Ph e #(
Site Address D City t Zip
Owner Address City State Zip
Tax Parcel No. (Confirm with Assessors Office) - '`z - l��f��/� Legal Description_
Project Description
2e,
DirectiorA to site (Please attach map
Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc.
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?
County yes
❑ ❑ 1. Saltwater shoreline or a lake 20 acres or larger?
❑ [J 2. Rivers, streams, or creeks with year-round flow?
❑ ❑ 3. Rivers, streams or creeks with intermittent flow but are within a clearly defined channel?
❑ 4. Lakes or ponds less than 20 acres in size?
❑ 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 greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for
guidance.)
❑ ❑ 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map
for guidance.)
❑ ❑ 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:
County yes
❑ [� 1. Agricultural Open Space Taxation Program, RCW 84.33
❑ ❑ 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest,
RCW 84.34
Copies are available at Mason County Department of Community Development for $5.00 each.
PAc1S OF RFARIN&M �3
I MAI DFS_Y`J7IPTTON
ik-
Ol
y
al awe
TDQ IN - --
ECUIP4ENT PROCEDURE
=WIMN! LOCH S'TOTAL S7ArAV
AND CAL■RAIM CHIW
PROCIEDtAte FIELD TRAVWM
IFS
0 -ems.ROW r/t;ASM CAP WT norkly fot AGAM LAW SMVEYM
Ls PROFESSICKAL LAND SJRVC"
O D/b'mam r/PI.m r- 25M AGAM AM (20)478-072
-w L IFMAL MI Sk MM4
■ -am LOO CPA" M DATE .0 ND
9-raMA W I- .aif� �-a-ae ss-Ha
-wc>+AL M�M er srxE sir
0
J71Q &QA A