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Home My WebLink AboutBRN2012-00033 Land Clearing - BRN Permit - 11/14/2012 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W. Cedar P.O. Box 279 . Shelton, WA 98584 i� BURN PERMIT BRN2012-00033 OWNER: HARRY GRIFFITY III RECEIVED: 11/14/2012 CONTRACTOR: LICENSE: EXP: ISSUED: 11/14/2012 SITE ADDRESS: CARMEN RD NORTH SHELTON EXPIRES: PARCEL NUMBER: 420152400000 LEGAL DESCRIPTION: SE NW EX PROJECT DESCRIPTION: DIRECTIONS TO SITE: land clearing permit SHELTON MATLOCK RD, R ON CARMEN RD NORTH, FOLLOW TO THE END, FOLLOW UP HILL TO LEFT. BURN TYPE: FEES Land Clearing Type By Date Amount Receipt Burn Permit GMM 11/14/201: $160 50 S1201200000000001527 Total $160.50 BRN2012-00033 Please refer to the following pages for conditions of this permit. Page 1 of 4 CASE NOTES FOR BRN2012-00033 CONDITIONS FOR BRN2012-00033 1) Permit in s two (2) inspections maximum, additional inspections will require a $73.00 re-inspection fee. X 2) Applicant all all 360.426.4441, EACH day to report burning activity. Last 3 numbers of permit required at time of call in. X 3) Applicants 11 360.586.1044 (ORCCA) EACH day to report/request any air quality issues associated with burning. X y 4) Valid per t be on-site while burning. X 5) A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void. After a burn ban has been implemented, all fires my extinguished immediately. _ X 20 6) The following materials may not be burned: Garbage, dead animals, asphalt, petroleum products, paints, rubber products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural vegetation)that normally releases toxic emissions, dense smoke orf6xious odors when burned. X 7) All mated t originate from the property on whichthe burning is to occur. X 8) The fire of create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property. X 9) The may pile size is twenty (20) feet in diameter, with a minimum ten (10) feet firebreak around each pile. X 10) Each pile t be at least one hundred (100) feet from any structure and atleast fifty(50)feet from standing timber. X BRN2012-00033 Please refer to the following pages for conditions of this permit. Page 2 of 4 11) Do not bu ) ind is blowing more than seven (7) MPH. • X 12) Do not bur ind is blowing from XX direction. (This will be indicated on the posted permit at the time of site inspection.) ' X 13) A minimum of one qualified operator is required to be in attendance at the fire while burning. A burn site/fire shall never be left unattended. MUST PROVID OUR FIRE WATCH. X 14) On Site Water is required between April 15th and Oct. 15th. The pump truck or trailer must have 300 gallons of water loaded and 200 ft of hose. (Pump must be c of pumping 20 gallons per minute through a one-inch (diameter) 50-foot hose.) X 15) It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished. Permitted individual is responsi f any rekindling on the fire/burn site. X 16) Provide for/dozer with a fire extinguisher at the site with a qualified operator. X 17) Provide - our fire watch. X 18) The person in charge of the fire will be liable for the cost of suppression if the fire gets out of control or if becomes necessary to extinguish the fire as the result of�rcement action. X 19) Access mu passable with 2 wheel drive vehicle. X 20) Fire must pletely extinguished within three (3) days after ignition. X 21) After the burn,jpmplete, YOU MUST touch by hand, the earth to make sure the fire has not burned down into the earth. X 22) Fan is req X f BRN2012-00033 Please refer to the following pages for conditions of this permit. Page 3 of 4 This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection. The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to,the above described property and structure for review and inspection. *�4 OWNER OR AGENT: t�d&� DATE: �l 7 BRN2012-00033 Please refer to the following pages for conditions of this permit. Page 4 of 4 W X z CONCRETE MECHANICAL MANUFACTURED HOME O Date By ;` tv Footings!Setbacks Gas Piping Ribbons -n 0o Intenor Date By Interior-Date By Date By ow Exterior Date By Exterior-Date By Set-up Point Load Isolated Footings INSULATION Date By BG f SLAB INSULATION = Date By Data By FIRE DEPARTMENT > Foundation Walls Floors Date By X Date By Data By DECKS FRAMING walls Date By Date By Data By PROPANE TANKS PLUMBING vault Date Sy Date By OTHER Groundwork Attic Date By Date By Type- Data By D.W.v DRYWALL Type- Date By Int.Brace Wall Date By v a) Date By FINAL INSPECTION Z CD Water Line Fire Separation /� N m Date By Date By Date (I ISM /Z By AO/ O p N g Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments o 0 1 J s' cn v m N O 0 O 7 a o' CA 0 N CD CD 1 3 ^`V W CD .f O H. BRNz01z-� MASON COUNTY BURN PERMIT APPLICATION 426 W CEDAR ST. • PO BOX 186• SHELTON WA 98584 SHELTON 360.427.9670 •BELFAIR 360.275.4467 •ELMA 360.482.5269 APPLIC�11'1 I�1 TI _ CONTRACTOR INFORMATTnN• Owner I�`// �' /c(/ff Owner MEER:7Ce Mailing Address C State Zip City tate Zip Pll Phone-,Zr`1B'g4l" Phone th r Phone Lien/Title Holder Contractor Reg.# Exp. E-mail address %fJ E-mail address Drivers Lic.# if dt DOB / 3 K 7 Drivers Lic.# D.O.B. TAX PARCEL NUMBER Sec. lr-:;_TwnvDD Rng. Fire District SITE ADDRESS(please include street name,number&city W O( �°/17j 'Sff�GTC�69> Directions to the site Parcel within 200'of: SaltwaterR Lake❑ River/Creek❑ Pond❑ Wetland❑ Seasonal Runoff'❑ Stream❑ Slopes or Bluffs> 15% Yes/ O Will timber be cut and sold in parcel preparation?Yes o Does Site require FPA or 6 yr.Moratorium:Yes/No Is site being converted or replanted:Yes/No Reason For land Clearing /-/f} A Q& Is this application the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes o BURNING IS AUTHORIZED SUBJECT TO THE FOLLOWING CONDITIONS: • Valid permit must be onsite while burning • The following materials are prohibited and must not be burned: garbage, dead animals, asphalt, petroleum products, paints, rubber products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural vegetation)that releases toxic emissions,dense smoke,or obnoxious odors when burned. • All materials must originate from the property on which the burning is to occur. • The fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and property. • Maximum pile size is twenty(20)feet in diameter,a minimum ten(10)feet firebreak must be constructed around each pile. • Each pile must be at least one hundred(100)feet from any structure and at lease fifty(50)feet from standing timber. • Do not burn if wind is blowing more than seven(7)miles per hour.DO NOT BURN IF WIND BLOWING FROM • A responsible adult and equipment shall be on site and in attendance at the fire while burning.Must provide 24 hour fire watch. • On Site Water is required for permits between April 15"'and Oct..I5 h.A pump truck or trailer with 300 gallons of water loaded and 200 R of hose.(The pump must be capable of pumping 20 gallons per minute through a one inch(diameter)50 foot section of hose.) • Provide EXCAVATOR/DOZER(with fire extinguisher)on site with gualified operator. • Fire must be completely extinguished within three(3)days after ignition • Fan required. • Upon completion of above conditions,applicant must have inspection&approval before ignition.Call (360)427-9670,ext.262 • Applicant's must call 360.426.4441,EACH day to report burning activity.Last 3 numbers of permit required at time of call in. • Applicants must call 360.586.1044(ORCCA)EACH day to report/request any air quality issues associated with burning. • After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots. • It is advisable to pump the entire content of the water tank onto the bum site to assure the fire is completely extinguished. The permitted individual is responsible for any rekindling on the fire/bum site. • A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a bum ban has been implemented,all fires must be extinguished immediately. • Permit includes two(2)inspections maximum,additional inspections will require a re-inspection fee.(at current rate) • Access must be passable with 2 wheel drive vehicle OWNER/CONTRACTOR: Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed.The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County&local fire authorities access to the above described property and structure for review and inspection.The person in charge of the fire will be liable for the cost of suppression if the fire gets out of control or if becomes necessary to extinguish the fire as the result of an enforc ent action. X 117" A_ Z& Date f �� Indicate ow r/Applican epresen ative