HomeMy WebLinkAboutSPI2005-00039 - SPI Application - 2/8/2005 r 's
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PLANNING DEPT. PRE-INSPECTION APPLICATION
PLEASE PRINT $205.00 Fee Required
1. Owner: _At& &hAie� Applicant:
Site Address: 0 Applicant Address:
Owner Address: 4 w51L? City: St Zip
City: - St Zip _ Phone:_) day
Phone:_( Vi day Phone:_(_) evening
2. Parcel No. 00,E
Parcel No. - - Email Address: cow,,
Legal Description: �� 2 $ e�J S-5rJ Planner:
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SMP Comp.Plan Type of Use
Water Body
3. Purno f Pre spection
00 -
4. Use of Building:
5. Do any of the following exist on or adjacent to property?: slope(K) saltwater lake ) river
pond( ) wetland( ) seasonal runoff( ) other ) stream ) seasonal creek(
Directions to Site: /
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If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies in the original
application. Pre-inspection reports remain valid only until development changes occur in the vicinity which affect the lot
evaluated in this inspection, or the laws regulating development of the site change after the time of inspection.
Applicant Signature: Date:
If you would like to be on site during inspection,please check here: (� l (�� FEB 0 i� 5
Return application to: Department of Community Development,Planning Division
426 W:CEDAR STI
P.O. Box 279
Shelton,WA 98584
(360)427-9670
Please include a$205.00 check or money order payable to Mason County Treasurer
When completed, this form becomes part of the parcel file.
FOR OFFICE USE ONLY: Accepted by: Date:
MORE ON BACK SID
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1:\PLANNING\CHARELL&RENEE\PRE-INSPECTION Revised: 11/15/04
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Please illustrate below the proposed building site in relation to water and property lines:
Departmental Review
(For Office Use Only)
Planning Department Findings:
1:\PLANNING\CHARELL&RENEE\PRE-INSPECTION Revised: 11/15/04
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