HomeMy WebLinkAboutGRD2022-00002 - GRD Application - 8/1/2022 eozz co :.,
�. MASON COUNTY PERMIT NO. r(IZj.2Z-W60
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•FIRE MARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg.8, (360)275-4467 Belfair ext.352
1854 615 W.Alder Street, Shelton,WA 98584 (360)482-5269 Elrga'ext 352
LAND MODIFICATION PERMIT (Grading Permit)
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Michael Ricketts NAME: r tre t
MAILING ADDRESS:340 E Olympic Vista Drive MAILING ADDRESS:
CITY:union STATE:wA ZIP:98592 CITY: STATE: ZIP:
PHONE:602-819-1225 CELL:n/a PHONE: CELL:
EMAIL:michael@rickettstrucking.com EMAIL :
L&I REG# /13
/
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) 32232-34-90012 FIRE DISTRICT union
LEGAL DESCRIPTION(ABBREVIATED):S 400'OF E1/2 SE SW EX TR 2 OF SP#2194#546501 PCL 2 OF BLA#96-48#629942 S 51/2
SITE ADDRESS XXX E.Dalby Road
CITY Union
DIRECTIONS TO SITE ADDRESS
In Union on the NE corner of McReavy Road and Dalby Road, behind gas
station to the NE in large clearing
IS PROPERTY WITHIN 200 FT:
SALTWATER❑ LAKE ❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES E] NO❑
WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES❑ NO EJ
TYPE OF JOB: EXCAVATION Q FILLING E] GRADING E] CUTTING ❑ OTHER
TOTAL SIZE OF PARCEL 3.22 ac ACRES/SQ FT SIZE OF AREA TO BE EFFECTED 2.89 ac ACRES/SQ FT
ESTIMATED AMOUNTY OF CUBIC YARDS 16,600 cy
DOES THE SITE HAVE SLOPES 14%OR GREATER YESQ NOD
DESCRIBE SCOPE OF WORK
Site preparation and development of building and parking storage
WILL FILL BE BROUGHT ON SITE? IF YES,SITE ADDRESS:Possibly.Local Quarry
WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS: No
DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES❑ NO E]
HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES Q NO❑
WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF ? YES❑ NO E]
WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES❑ NO E]
WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES Q NO[]
WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES E] NO❑
WILL THE LAND BE REPLANTED UPON COMPLETION? YES E] NO❑
WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES 0 NO❑
IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES❑ NO
OWNER/BUILDER 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,owners legal representative,or contractor. I further
declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary
parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for
review and inspection.T ' ermit/application becomes null&void if work or authorized construction is not commenced within 180
days or if n truction>tWk is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF
INSPECT ITY OF T 15 PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
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