HomeMy WebLinkAboutSPI2005-00031 - SPI Inspections - 2/4/2005 MASON COUNTY UJ
PLANNING DEPT. PRE-INSPECTION APPLICATION %
PLEASE PRINT
$205.00 Fee Required
10 Owner: jA/Z �/f� Applicant: ,6
Site Address: fA Applicant Address:
Owner Address: t- City: � y ` St ��4 Zip
City:,S u,�P6 ' St Zip Phone:_(36�) ay
Phone:
_Q3 Wad day Phone:_(36n ) 4/27zga/ evening
2. Parcel No.
Parcel No. - - Email Address:
Legal Description: 0 �/ % L� Planner:
L L
SMP Comp.PIa�Type of Use (_K(-_,-,
Water Body
3. Purpose of Pre-Inspection 741f/���
4. Use of Building:
5. Do any of the following exist on or adjacent to property?: slope V J saltwater( lake river
pond ( wetland( seasonal runoff( other( stream seasonal creek
Directions to Site: 'ALM Lziia
F
/10% D ` , _7 0
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 gulating development of the site change after the time of inspection.
Applicant Signatu L Date:
Ifyou would like to be on site during inspection,please check her .
Return application to: Department of Community Developmen ,Planning Division Q
P.O. Box 279 R�CC/I,
Shelton, WA 98584 F < V
(360)427-9670 FB 0
a?6 � 4 2Dp5
Please include a$205.00 check or money order payable to Mason County Treasurer cE0
When completed, this form becomes part of the parcel file. •4R Sr'
FOR OFFICE USE ONLY: Accepted by: Date:
MORE ON BACK SIDE
I:\PLANNING\CHARELL&RENEE\PRE-INSPECTION Revised: 11/15/04
Please illustrate below the proposed building site in relation to water and property lines:
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Departmental Review
(For Office Use Only)
Planning Department Findin s:
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1:\PLANNING\CHARELL&RENEE\PRE-INSPECTION Revised: 11/15/04
MASON COUNTY
PLANNING DEPT. PRE-INSPECTION APPLICATION
PLEASE PRINT $205.00 Fee Required
1. Owner: Applicant:
Site Address: Applicant Address:
Owner Address: City: St Zip
City: St Zip Phone:_ ----J day
Phone:_(__) day Phone:_(____) evening
2. Parcel No. - -
Parcel No. - - Email Address:
Legal Description: Planner:
SNIP Comp.Plan Type of Use
Water Body
3. Purpose of Pre-Inspection:
4. Use of Building:
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:
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:
Return application to: Department of Community Development,Planning Division
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 SIDE
1:\PLANNING\CHARELL&RENEE\PRE-INSPECTION Revised: 11/15/04