HomeMy WebLinkAboutGRD94-0001 - GRD Application - 1/13/1994 GRD Q 0`
MASON COUNTY
LAND MODIFICATION PERMIT
Grading, Excavation, Fill, Slopes, Drainage
Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT 1
#1 Owner V C Y1� A Y�C2 I A Phone Cz— Fire District#
,bite Address�200 WL�s Cit 23fi Z-`rn/y St Zip �
;Owner Address City St Zip
Describe Work
#2 Contractor Name ("30 GmS19614 tA I J Contractor Reg #
Address ,d �U Expiration Date
City Aloe.,- rev, StWAzip c78 S Phone#
#3 Engineer's Name Phone#
Address City St Zip
30 9YO,2�
Parcel No. - -
Legal Description
#5 Number of cubic yards to be excavated:
Number of cubic yards to be filled: 3 S&C
Number of cubic yards to be graded:
#6 Will this be a balanced cut and fill entirely within the site?
Yes No k—
If No: Will fill be brought on site? Yes No o /�
Where does imported fill originate from? /� m— *f � Si 'a"
Does fill contain any potentially hazardous materials?
Yes No X, - EGE H E
gQ t�, J SC TO �O GotJ i Ar i t d
Soccs �s--r, aN 1 3 1994 ID
#7 Will excavated materials be taken off site?Yes No �- —GrE NERAL SERVICES
If Yes: Where will excavated materials be taken?
I
#8 Brie escribe ex'sting terrain, vegetation, nd improveme/nts on subje t site? d
06 O 11/`
#9 Total size of area to be cleared O acres/sq ft
Size of area to be cleared on slopes over 10% AC/SF
#10 Has a soils report been completed on the subject site?
If yes, include copy with application.
#11 Is the subject site within 200 feet of a designated shoreline f'1
#12 Does the subject site contain any of the following features?
River Lake VLWetlands_1X1 Saltwater
Slope greater than 15% Soft compressible soils
Seasonal Runoff None
#13 Will the proposed land surface modification change the points
where storm water or groundwater enters or exits the site?
#14 Will the proposed land surface modification change the quality,
quantity, or velocity of storm water/groundwater? D
#15 What methods, if any, will be utilized to minimize erosion and
possible sedimentation into nearby waters during and after
construction? AO'o
#16 Will this land modification result in the redirection of any surface
water runoff onto adjacent properties? /7 z) e:
#17 Will surface or subsurface runoff be collected or controlled by
interceptors, curtain drains, or other water collection devices
once this land modification has been completed? 140
#18 Will the land be replanted upon completion?
If yes, with what types of plants?
#19 Will this modification result in slopes steeper than those currently
on the site? If so, how steep?
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences AI
Structure Setbacks Driveways / y
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements Indicate Directior_y (N, S, E, W)
Name of Flanking Street in relat6n-To plot plan
Name of Fronting Street
APPLICANT TO DRAW SITE P=OW
0
GJ D
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED
WITHIN 180 DAYS OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT
ANYTIME AFTER WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS IN.
SPECTION.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE
CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT
X OWNER X BY LZf/t--
G
DATE — 3_ / DATE
FOR OFFICIAL USE ONLY:Accepted by: _ Date:
DEPARTMENTAL REVIEW
Planning APP COND APP HOLD
Building
1L AYQV-4� `
Environmental
Other
Special Conditions FEES
® 'Se�,l L-
Grading Permit
OF 6OLvS
MIN-sw , -�E Plan Review
L�C�1✓►L t S CZ\L, i Site Inspection
Violation Fee
Other
TOTAL FEES $ D 0
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton,Washington 98584
(206)427-9670
BUILDING PARKS & RECREATION FAIR/CONVENTION CENTER ADMINISTRATION
January 14, 1993
Field Report
John Kneeland Site
200 West Wallace Blvd
Shelton, Wa.
A field inspection was conducted on the above site by Don
Brush, Mason County Planning and Mike Byrne, Mason County Building
Official in response to a Land Modification Permit application.
The applicant is proposing to deposit 3500 cubic yards of
humus soil from the Wal-Mart site to the above site .
The site is identified as a gravel pit . Gravel has been
extracted from the area for a number of years . The location of the
soil storage is at the Northeast portion of the pit next to a bank
and burm that separates the wetlands from the pit area.
The placement and grading of this soil is exempt in accordance
to UBC Chapter 70 , Section 7003 , 1 . The exemption is being issued
pending confirmation of the D.O.E . and the Mason County Health
Department that the soils report provided by the applicant is valid
and accurate . There are no other apparent environmental or safety
factors that would effect this exemption determination.
by,
r
Mike Byrne, Building Official.
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�-�\ 1'� / o oz THIS PLAN SUPERSEDES SHEET 12
OF 12 SiE--_S OF SR 101, COLE ROAI
� INTERCHANG= TO NORTH SHcL'ON
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GARY YANDO,DIRECTOR
P�oN.STgrFo
O A u N
DEPARTMENT OF COMMUNITY DEVELOPMENT
o T i PLANNING -SOLID WASTE-UTILITIES
Z� N Y y BLDG. III • 426 W. CEDAR • P.O. BOX 578
of 1864 SHELTON,WA 98584 • (206)427-9670
May 11, 1993
John Kneeland
P.O. Box 81
Shelton, Wa. 98584
Re: Building Permit; location west of Hwy. 101 and Wallace
Boulevard interchange.
Dear Mr. Kneeland:
I have attempted calling you with no luck. Before we can sign off
your permit the following information is needed.
1 . Will access be on to a County or State road? A road access
permit will be needed from either Mason County or the State. We
must have proof that access has been obtained.
2 . The application notes that Goose Lake is 400-500 feet away.
Does the drainage from your site lead to the lake? We are
concerned with runoff from your site carrying contaminants to the
lake.
Your permit is on hold in the Planning Department until we hear
from you. Thanks for your help.
Respectfully,
Zon Brush, Planner
Department of Community Development