HomeMy WebLinkAboutSPI2022-00044 - SPI Inspections - 3/30/2022 MASON COUNTY RECEIVED SPA
COMMUNITY SERVICE§,.R 3 0 2022
Building,Planning Environmental Health,Community Health PLANNER
615 W.Alder St.-Bldg.8,Shelton,WA 98584 �_kA
Phone:(360)427-9670 ext.352•Fax:(360)4IM9,� W Alder Street
PLEASE PRDU $300.00 FEE REQUIRED
PLANNING DEPT. PRE-INSPECTION APPLICATION
Note:Pre-inspection does not survey lot lines and can only provide very general septic and water adequacy information.
i. Owner: :4-P N -0R i s 4-e LZ Applicant:
Site Address: 1= SNoRN.u < �1 ST a�ir,�i !.i!L Applicant Address:
Owner Address: g b i mgo s+, [J,v it City: St Zip
City: I C r»„ e St_ - Zip 9 -No Phone:( day
Phone:(2.53) 3'7 6 - 43 g ? day Email Address: C lMrzs . 1 o;r LI—r9 ce 601114111.. ear"
Phone: LS ;- _ 7 L.' "' evening
Legal Description: {-
2. Parcel No. �3 2 oz I
Parcel No. -
3. Purpose of Pre-Inspection:
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4. Use of building: Py-%.r to V0 l=
5. Do any of the following exist on or adjacent to property?: slope saltwater lake river
pond wetland seasonal runoff other stream seasonal creek
Directions to Site: //1N t,3 ;uZa 0 A)-b A c A-:Z' i?t, , �L�w A c,a-rS 196
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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: 3 zLo
If you would like to be on site during inspection,please check here:
Return application to: Mason County Community Services,Planning Division
615 W.Alder Street
Shelton,WA 98584
(360)427-9670 ext.352
Please include a S300.00 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 SIDE
Rev. April 2021
p A U f_ l o L -z
Please illustrate below the proposed building site in relation to critical areas (slopes, streams, lakes, wetlands, etc.)
existing improvements, as well as property lines. APPLICATIONS SUBMITTED WITHOUT ADEQUATE
ILUSTRATIONS WILL NOT BE ACCEPTED AND WELL BE RETURNED TO THE APPLICANT.
Departmental Review
(For Office Use Only)
Planning Department Findings:
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