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HomeMy WebLinkAboutRLC94-1308 for GRD94-0049 - RLC Inspections - 7/6/1994 r)o MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT RESOURCE LANDS AND CRITICAL AREAS CHECKLIST Permit Number 6 1a-SptA"L ( RLC# 94Al" Owner &tLC W ""114vum.) Parcel Number—jaw 322 3—1 l r DD 0 ❑ 1. Saltwater shoreline or lake 20 acres or larger? Name of Water Body ❑ 2. Rivers, streams. or creeks with year round flow??",tv\-- Type of Other Water ❑ 3. Rivers, steams or creek with intermittent flow but are wi clearly defined channel? ❑ 4. Lakes or ponds less than 20 acres in size? &4,.o ❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. }^ 0 �/ 4 6.. Slopes greater than 15% (8.5 degrees)? On Landslide Hazard Map?! 30 r 3,% vvv o� {'vc GI % of Slopes El 7. Floodplains? � � ����r� ❑ 8. Seismic Hazard Areas? hu �{ ❑ 9. Agricultural Open Space Taxation Program? ❑ 10. Open Space Timber Taxation Program, or Designated foresl ok Classified Forest? ❑ 11. Site has no Resource Lands or Critical Areas. p� - Comments: 6 cQ4 a`�,`L(, ,4,� --.- W14 -17) w- -Ile Authorized Signature Date ) Jo &'3)c- �c Y� PERMIT NO. DATE RECEIVED t MASON COUNTY fir;:��,�*T1 ARTMENT OF COMMUNITY DEVELOPMENT INTERIM RESOURCE ORDINANCE (Chapter 17.01 MCC) CourthopbaNiZh c 08%26 W. Cedar/P.O. Box 578, Shelton, WA 98584, 427-9670/1-800-562-5628 MASON CO. p,�NoNG DEPT. ENVIRONMENTAL PERMIT APPLICATION The purpose of the Interim Resource Ordinance is to protect Mason County's natural resource lands and critical areas and is under the authority of Chapters 36.32, 36.70A, 39.34, 58.17, 76.09, 84.33, 84.34, and 90.58 RCW. PLEASE PRINT a1 Owner Al odG ",4- Ucr.Lc1 Phone# Site Address �S-�O �l u _f U 6 Fire District A► City j D a State 4iC-A- Zip %PJ-fr-L- Owner Mailing Address City_l zo jC7 t,- State Lien/Title Holder 6&t,t Address City State Zip -ryaLTT-32-23 Y- 43 002-6 0 Tract-/6- 3.)-a7`1 - 113 - ot7i-7 10 #2 Parcel No jrn,-07-lax3H -ti1- DOS 0 Legal Description Parcel Size ` ©©n Ar Z_�d #3 Directions to site (Please attach map) q 10 — z Sr 0eo, 'e -o 7� `� '�' #4 State what Sections required a permit: Long-Terra Commercial Forest, Chapter 17.10.060; _ Inholding Lands, Chapter 17.01.062; _ Mineral Resource Lands, Chapter 17.01 .066; _Wetlands, Chapter 17.01.070; _ Critical Aquifer Recharge, Chapter 17.01.080; _ Aquatic Management Areas, Chapter 17.01.1 10; Geologic Hazard Area: _ Frequently Flooded Areas, Chapter 17.01.090; _ Landslide Hazard Areas, Chapter 17.01.100; _ Seismic Hazard Areas, Chapter 17.01.102; `Erosion Hazard Areas, Chapter 17.01.104. #5 Identify current use of property itl a isting improvements: , l S'f'r&OX .lCG1 d #6 Identify and describe the proposed project, including the type of materials to be used, construction methods, principal dimensions, and other pertinent information (Attach additional sheets if needed): #7 Any water on or adjacent to property: Saltwater_Lake_River_Pond_Wetland_Seasonal runoff— Other #8 Will there be an alteration of a wetland and/or wetland vegetation areal _Yes K No #9 If septic is located on project site, include records. Connect to Septic? Community Septic? Public Water Supplyl Well? L� N10 Type of Job: Newt/Ad&j�� Alt Repair Demolition Other�/t���CJ��� This permit is granted pursuant to the Interim Resource Ordinance (Chapter 17.01 MCC) and nothing in this permit shall excuse the applicant from compliance with any other federal, state, or local statutes, ordinances or regulations applicable to this project, but not inconsistent with the Interim Resource Ordinance. The permit may be rescinded pursuant to the event the permittee fails to comply with the conditions of this ordinance. v Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic System Wells Indicate Directional by (N, S, E, W) Proposed Improvements Easements in relation to plot plan. Name of Flanking Street APPLICANT TO DRAW SITE PLAN BELOW c� �j /G 0 APPLICANT TO DRAW TOPOGRAPHY BELOW DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Environmenta ealth: Buildin an Review: Occupancy Group: Fire Marshall: Other: C 0 nd i 'tt on s: I 1 1 1 i 1 1 1 I I I 1 1 1 1 1 1 I I w 1 TOTAL FEE Accepted by: Date: