HomeMy WebLinkAboutBRN2014-00016 Land Clearing - BRN Permit - 6/25/2014 •+ • Inspection Line(3bU)4L/-tZbZ
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
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BURN PERMIT BRN2014-00016
OWNER: GREG STAIRS RECEIVED: 6/25/2014
CONTRACTOR: LICENSE: EXP: ISSUED: 6/25/2014
SITE ADDRESS:
EXPIRES:
PARCEL NUMBER: 322325201001
LEGAL DESCRIPTION: UNION-GRAYS HARBOR & UCRR ADD BILK: 1 LOT 1-28
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
LAND CLEARING BURN PERMIT PROPERTY ACCESS OFF ALDERNEY, MCREAVY, L ON 5TH, L
ON PORT TOWNSEND, R ON ALDERNEY
BURN TYPE: FEES
Land Clearing Type By Date Amount Receipt
Burn Permit GMM 6/25/2014 $160.50 S1201400000000000672
Total $160.50
BRN2014-00016 Please refer to the following pages for conditions of this permit. Page 1 of 4
CASE NOTES FOR
BRN2014-00016
CONDITIONS FOR
BRN2014-00016
1) Xerrrhjt i�u�jes two (2) inspections maximum, additional inspections will require a$73.00 re-inspection fee.
2) A X p2r ff 11st call 360.426.4441, EACH day to report burning activity. Last 3 numbers of permit required at time of call in.
3) Applic�nm
X ��jj It call 360.586.1044 (ORCCA) EACH day to report/request any air quality issues associated with burning.
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4) Valid gerft rest be on-site while burning.
X .�J'�T �
5) A BURN BAN hen 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�n extinguished immediately.
X ��
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
s mokeorKI
ious odors when burned.
7) All mate,�iaJ st originate from the property on whichthe burning is to occur.
X �2
8) The fire'gu t create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property.
X_��
9) The may i size is twenty (20) feet in diameter, with a minimum ten (10) feet firebreak around each pile.
X
10) Each pi s e at least one hundred (100) feet from any structure and atleast fifty (50)feet from standing timber.
X
BRN2014-00016 Please refer to the following pages for conditions of this permit. Page 2 of 4
_v) Do not bur i wind is blowing more than seven (7) MPH.
X
12) Do not burn d 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
PROVIDE UR FIRE WATCH.
X ,,,,��
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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 I f pumping 20 gallons per minute through a one-inch (diameter) 50-foot hose.)
X �r
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
responsib a fqp' y rekindling on the fire/burn site.
X �[t
16) Provide dozer with a fire extinguisher at the site with a qualified operator.
X
17) Provide a,24epbupfire watch.
X : 'n
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 2n f+ement action.
X „6
19) Access rtapassable with 2 wheel drive vehicle.
X__
20) Fire mu b of letely extinguished within three (3) days after ignition.
X
21) After th®bwrX i omplete, YOU MUST touch by hand, the earth to make sure the fire has not burned down into the earth.
22) Fan is repuj�d�
X
BRN2014-00016 Please refer to the following pages for conditions of this permit. Page 3 of 4
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. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if
construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLIC ION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
9 L-1-- 6 , -1,3
Signature 7
�` Date
re i J r 13- OWNER - REPRESENTATIVE - CONTRACTOR
Print Name Ili (Circle one to indicate)
BRN2014-00016 Please refer to the following pages for conditions of this permit. Page 4 of 4
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Footings/Setbacks DatePiping Ribbons
o Interior Date By Interior-Date By Date By f/)
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rn Extenor Date By Exterior-Date B Set-up INSULATION X
Point Load/Isolated Footings gate By gG SLAB INSULATION M
Date By Data By FIRE DEPARTMENT
Foundation Wails Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date By Data By PROPANE TANKS
PLUMBING vault Date By
Data By OTHER
Groundwork Attic
Date By Date By Type:
Dale By
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-0 Date By
Int.Brace Wall Date By W
w Date By FINAL INSPECTION Z
y Water Line Firs Separation N
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Date By Date By Date By O
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BRN2014-
MASON COUNTY BURN PERMIT APPLICATION
426 W CEDAR ST. •PO BOX 279 • SHELTON WA 98584
SHELTON 360.427.9670 •BELFAIR 360.275.4467 •ELMA 360.482.5269
APPLICANT INFO N• CONTRACTOR INF TION: /
Owner r 2. ; r Owner �QQ_ f�-- .Sns l D
Mailing Qddkes Mailing Address
City u 1j I Q State Zi I City State Zip
Phone Cell Phone Phone Other Phone _
Lien/Title Holder Contractor Reg.#
E-mail address E-mail address
Drivers Lic.# DOB — Drivers Lic.# D.O.B.
TAX PARCEL NUMBER 31- ti Sec. Twn. Rng. Fire District
SITE ADDRESS(please incl street name umber&city
Directions to the site
ti
Parcel within 200'of. Saltwater❑ Lake❑ River/Creek❑ Pond❑ Wetland❑ Seasonal Runoff❑ Stream❑
Slopes or Bluffs> 15% Yes/ Will ber be cut and sold in parcel preparation?Yes/
Does Site require FPA or 6 yr.Morato 'um:Yes Is site being c nverted or replanted: e o
Reason For land Clearing
Is this application the result of a Stop Wor otice,Correction Notice or other enforcement action?Yes
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 bum 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 15t'and Oct. 15`s.A pump truck or trailer with 300 gallons of water loaded and
200 ft 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 qualified 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 bum 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/burn site.
• 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 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
percussion 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 enforcement actin .
X Date
Indicate o er/Applieant/Representative