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Home My WebLink AboutRLC Application - 10/21/1993 .� Date Received: 10 _2 i -i 3 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT RESOURCE LANDS AND CRITICAL AREAS CHECKLIST 0 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, 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 Phone #� Site Address ty—s 7' �.� v -�'/�E/Tc t, 71r.�7`.G-� �Tcity Owner Address ?,&7r A7,5-e- City Statel%�Zip 5$ Tax Parcel No.42 C'rr Legal Description 4: �� 4LL- Directions 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 Ym No ❑ ❑ 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? ❑ ❑ 4. Lakes or ponds less than 20 acres in size? ❑ ❑ 1(�' 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.) ❑ ❑ d 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for guidance.) ❑ ❑ [j 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) ❑ ❑ [�J 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 No ❑ ❑ ❑ 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. RESOURCE LANDS Bic CRITICAL AREAS ` SITE PLAN PLEASE 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,drainfields, wells &driveways. Scale 1"= North Arrow state that I have ans red the above truthfully to the best of my knowledge. Applicant/Owner ��' aG�i3 Date FOR OFFICIAL USE ONLY Adjacent property. Using County;,Resource_l..and Maps, this property is designated as 1 long Term Commercial Forest Land 3: Mineral Resource l.anci. ' .::..;:.: ... 2 Infinldirtg L�ncf 4. Do(,s not apply. :::::. .... taC .........<..:::.. . date 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. I, - 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-Sit wag? *aAff� e Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Hazardous WaImun ste P , or Sl94reline Permit in determining whether their property is affected by regulations under the Mason County lnte�E' urce 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 /J 01) ayg Phone #(,?C& $(o(o-Z&6( Site Address I EST' ?.O City SNE[TDrJ Zip Owner Address SA-M AS 4aa/F City State Zip Tax Parcel No. 2-01! -1_- 0001,0 Legal Description W, 208 ' of TR T- I of /VE flN I)E '� Tj� -20- Directions to sit ease attach map) Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc. I Ansvi-er t`o, fc!!cvving to the best of your knowledge. County-wide maps sh-wing 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 Yea No ❑ ❑ �'J 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? ❑ ❑ ,� 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.) ❑ ❑ I' 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 Ya No ❑ ❑ ❑ 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 Developmont for 55.00 each. RESOURCE LANDS & CRITICAL AREAS SITE PLAN PLEASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE: ► Location &dimensions of existing & proposed property boundaries. ► Approximate slope of land (grade &direction), topography. P. 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,drainfields, wells &driveways. Scale 1"= North Arrow FtP6crc4ED I state that I ha e answered the above truthfully to the best of my knowledge. v— Z1112 113 l Applicant/Owner Date FOR OFFICIAL USE ONLY Adjacent property. ><'•< : tit4::.{.:+•.:•.:;i5::'•:`•±::±:>�t�S;;:3�;:i;; iii2<`$3:2 .i:.3:.i..:•3i :.i`ii;�<'+i :>�:353: �i<i :�3:�r:�S:$>3�£>:�:�:�if::is�i::�33: :�ri:#�:�:`•:`:�:�:?�5•;�••'•`�%it �y2+:; •i::::•:::::ii:.:::::..::•::L:+i;•...:\........:. .......+..........'d;::::::•i;.,......::.:::,v...G::T}}+:•:ti•i;:n;•:;:::}}:{•:•:+.:}:t{{• .. .......................:i:tr.:•:�:.T:.: .�:::..;i:.:.:::::>::::.•.:::..:.:..::•.:�::.:::.:...:::::.:::::.:::::.::..�..:::.::{:.::�:::rv;::{:::;;:: Usr ;Gcaun < e>:::::::> »_>:........ .. .n. ... . . ... . 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There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Mason County Treasurer. When completed, this form becomes P PP art of the permit application. I/ HOME OF J Town &Country_ POST FRAME BUILDINGS Suite B • 16521 Highway 99• Lynnwood,WA 98037-3161 Everett:(206)258-4171 Puyallup:(206)840-9552 Administrative Headquarters:(206)743-1555 — �— FAX:(206)742-1691 Toll Free: 1-800-824-9552 DIVISION OF Contractor's Lic.#:TOWNCPF099LT Quality: Our Future Depends On It.TM DIRECTIONS TO SITE JOB NAME: ot4 NI NROb &U-a SHIP TO ADDRESS: U) . 720 SFl�F�ToK-N(f}T1�pClG , Sh EG-T N UJ A TELEPHONE#AT JOB DROP:�/27 7,2-`I 9 THOMAS BROS. MAP LOCATOR S F-E M A-'P / Can a semi' turn around at the job drop? m Yes ❑ No ❑ Back-in Only ❑ Other Can a one ton get into the job drop? VYes ❑ No ❑ Other Can a concrete truck get into the drop? [(Yes ❑ No ❑ Other Directions �p� A-NGl:tts R Sttizl roH ARi��'s A I RYA i SO ti a S to PLT,Q 7ATt c7 cy V -DAY-roN r I MR iLocK -71 (� 11A6tOT C�,u 13 19 k I-r T L,G_ MA:_ I .-y CGvrT (-�o iR-D OL`/ A7 /A 'Truck Dimensions: 65' long, 8' wide, 121/2' high, and it weighs 35,000 lbs. empty. 1. Office—White 2. Construction Office—Canary 3. Concrete Crew—Pink ?1991 Perma-Bill Industries FR35 10/91 —' b HOME OF Suite B • 16521 Highway 99•Lynnwoou,WA 98037-3161 Town &CountI'Y_ Everett:(206)258-4171 Puyallup:(206)840-9552 Kenai,Alaska: 907 283-6050 POST FRAME BUILDINGS ( ) Administrative Headquarters:(206)743-1555 FAX:(206)742-1691 Toll Free: 1-800-824.9552 DIVISION OF Contractor's Lic.#: PERMABI 179JR Quality: Our Future Depends On It.T" Site Plan PEASE CHECK: Property dimensions [Septic and drainfield ❑Access to proposed building Existing buildings ❑$ewer lines El Lot size Existing building Setbacks of proposed and ❑Elevation of property ❑Easements existing buildings ❑Bodies of water dMain road with name ❑Floorplan wtsT 732o Sgr-I-Tom-MATLOCK Fb. Job name: �tHEL-I oN �I M1�-oD Ct.U$ Job Site Address: :ktF�T0ht Legal Description u). OF TLk8cT �r- IgEII� KFZ It-I 18'20-AI 'T>ARtyu No: y�Olf - I1- DDoIO 29 2H' 88� W6 L PRoYoSs-� sio' S t+rwro t4 N lkOolo CLUB I r -30 J a� FA} Y Acc1,9S t GfiAVE;L €& SiI NG Ni0' I SFt��To>tE I I N I M R C►- u 8 I I -IT F I I I I I__I Owner has verified and approved the loca fbn of accessories,orie taboo o t e buil mg tote north,and verifie at all items specified in paragraph B of the contract are shown on this drawing and vice versa. Customer signature: G IQ M.0.W(, �1RVEy VOL" 13 ) Pa, lbo 7! �/G p.Ep, AJ�Etop F1 , M'Ct(p.;Johl office(white) production(canary) production(pink) customer(goldenrod)