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Home My WebLink AboutMIS99-0424 Tank Abandonment - MIS Permit / Conditions - 7/23/1999 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 M I S.C E !- L- ^ N E C)U S PEE LAM 1 T FOR INSPECTIONS CALL 427-9670 MIS99-0424 PARCE PLATiDAPLO DIV - BLK : LOT : JOB ADDRESSs 3331"PW-311ELTON APPLICANTS RICHARD GATES 432-0924 OWNERS R I CHARD GATES 432- 0924 LEGAL : 8 SNELTONS 001 LAND CLAID 137 T1 32 333 IM `G' ST PROJECT DESCRIPTION : ox TANK ABANDONMENT � PROJECT LOCATIONS PROJECT NOTESS TYPE AMOUNT BY DATE RECEIPT MCFE $ 42 .00 NJP 07/23/99 50960 `r TOTAL ., 42 .00 OWNER 00 AGENT � DATE MIS TINT, rev: 14111102 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BGISLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date b date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by I date by MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 T C3ND 1 *T 1 CJN ` . Case No . : MIS99-0424 For : R i CIIARD GATES Page : 1 1 ? THE TANK ABANDONMENT CHECKLIST SHAIL BE COMPLETED AND SUBMITTED TO THE MASON COUNTY f= I R.L. MARSHAL WITHIN 15 DAYS Af TER THE STORAGE TANK IS ABANDONED . i CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set UP date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date b date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by I PERMIT NO.: MIS MASON COUNTY MISCELLANEOUS PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner R )C h a k, b4 t o .S Contractor Name Mailing Addr ss L J << / !if/ S Mailing Address City -t State cif} Zip Code 9$fir CI City State Zip Code Phone(3,<,0 V3'3L_0fa ther Ph.( h.( ) Other Ph.(_____) Lien/Title Holder Contractor Reg. # Address Expiration PARCEL INFORMATION-12 digit Tax Parcel No. / / Fire District Legal Description D an Czjo» ,0 3 Site Address(include street name and city Directions to site: Will timber be cut and sold in parcel preparation? (Yes/No) ,t,,O Is your property within 200' of the following: Body of Water (Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair I Other Use of Building Describe proposed construction Twh ber,, c .jme.-7-f- SHORELINE PROJECTS New Replacement Repair Expansion Bulkhead Material (concrete, rock, wood, etc.) Length Height A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF PERMIT. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work ordinance requirements regulating the work for which this permit is issued will be done in conformance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall first o inin ap ov �f be made without first obtaining approval. X Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by - Date "�/� Submittal Amount Due `--7 Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED CONDITION COD Building Department ✓e 17�7,a 7 re►-' Occ Grp Type of Const. Planning Department Environmental Health Department Public Works Department Fire Marshal Valuation $ FEES Building Permit Fee Site Inspection Plan Review Fee Other UFC Plan Review Fee _ Other Violation Fee Pre-Paid at Submittal ( ) TOTAL FEE S MASON COUNTY PROJECT SITE INFORMATION /p Case No. Name 4 d Gw f S PARCEL NUMBER y,1,0 13 Y5�4o-32gate SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg IN, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line4 , �j t" I E-adjacent property line I 6q 24�J� ✓✓ �-t o S e N►vVIS I I I I I I I I I I I I I I I O I I • I I I N- ' I / I I I I I I I I � I I I I I I I adjacent property line-) I <-adjacent property line SAMPLE SITE PLAN adjacent property line-> 2 _ Fadjacent property line �I I 17 30' rR�SC five_ 3�1 .SEASG_AL i• h _�EPT7L__,� i HOM 6 CREEK ]� I /♦0 tA..Sa \ 1 — pit I VAGNT 1 CrAMAC.6 PascD \ I P0.o I �� T a&2scu.LrwLAL 50' I 1 , I - I , Bo'—mil I I , L—e-LL I � I I I � /00' I adjacent property line-> i 1 a". \; E-adjacent ro ert'line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE ru.Ltl.�Y� diS't'iv�LG to 610pa. -to¢ dit+anal ignature Date -