HomeMy WebLinkAboutRLC99-105 - RLC Application - 8/10/1999 RESOURCE LANDS & CRITICAL AREAS CHECKLIST
Permit Number RLC# q q
Owner Ma-r t- �t��_►�C�_��Y-r Parcel Number 39934 -51 - 00007
1 . Saltwater/Lake 20 >_ acres Designation f�6
Name of Waterbody
❑ 2. Rivers, streams, or creeks Qa
Type of Water
3. Lakes or ponds less than 20 acres in size
El 4. Wetlands: Areas that are inundated or saturated by surface water that
under normal circumstances support vegetation adapted for life in such
conditions as the following: Marshes, bogs, and swamps. Q 6
El 5. Slopes greater than 15% or 8.5° If yes, degree of slope
6. Floodplain
` 7. Seismic Hazard Area
0- 8. Landslide Hazard Area
9. Aquifer Recharge Area fv��
El 10. Comp Plan Designation o V-
y Comments:
CC' f� Jt s !-f- n S- q - q q t) .nm c oc c) s
f
r-} up t r r r►Q 1',
c�nT�dclof�m�-
Authorized Signature Date
07/29/99 THU 10:28 FAX 3604278425 MASON COUNTY zoo-',
MASON COUNTY
RESOURCE LANDS & CRITICAL AREAS CHECKLIST
PLEASE PRINT $70.00 Fee Required
Applicant: �'//A �//��y.�� Ll�h,`f-� , Marcel No. d-�-�3
Applicant Address: P cQ (�c/7O �� c1
City: rlfv�SuaL_/ Zip 2 k"5` Legal Description: �
Phone:
l 3Go1 `fG .2loyG�
Owner Name (if diff rent from a licant: .
6 X, *4zG- 2G59, AHh
Purpose of Pre-inspection: y ��7�.e lrve �� .eG/�. /'Y �<sfi�f627S 6J .&Qk4V,
Use of Building:
Do any of the following exist on or within 200 feet of the property: saltwater lake
river/stream pond wetland seasonal runoff - slope _
Directions to Site;
Please illustrate in the box bel w the proposed building site in relation to property lines,
significant natural features, slope grade and direction and topography for include on separate
sheet):
North Arrow
�r ��IAWL G� -
This checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Site Evaluation and
Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Land Segregations, Hazardous
Waste Permit, or Shoreline Permit in determining whether their property is affect by regulations under the Mason
County Interim Ordinance (77-93). This checklist is an important opportunity for identifying early in the permit process
whether there will he any environmental regulations affecting the proposed development.
If the information is incomplete, then Mason County must disc aim any errors resulting from deficiencies in the original
application. Pre-inspection reports remain valid ly until v lopment changes occur in the vicinity which affects the
lot evaluated in this inspection,
Applicant Signature: ate:
)0 Roturn application to: Department of Community Development,Pfanning Division REUEVE
v • 411 W 5th(P.O. Box 578
[V 2— r Shelton, WA 99584 AUG p 6 1999
Plaaee mako checks or monoy ordora payable to Ma9on County Treasurer
When completed, this form becomes part Of the permit application.
PERMIT ASSISTANCE CENTER
07/29/99 THU 10:28 FAX 3604278425 MASON COUNTY 2003
'tease illustrate below the proposed building site in relation to critical area & property lines:
fl,4�- �YL
Departmental Review
(.For Office Use Only)
Planning Department Findings:
�� 1I