HomeMy WebLinkAboutMIS94-0393 Retaining Wall - MIS Permit / Conditions - 8/22/1994 i
i
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
MISC C L t- ANE70IL' RM
MIS94-0393 'PARCEL : 32 235
7n� n1� r NE 12481 NORTH SHORE RD BELFAIR
?..T DON BROWN 275-5080
DON W BROWN 275-5080
TR 3 OF 68VT LOTS 5 1 6 1 TAX 872-C 109 TR A OF SP 11126 SEE SURVEY 8/156 FS 14214 81 858
CT DESCP F;TON
RETAINING WALL
PF: OJECT LOCATION :
12 1/2 MILES OUT NORTH SHORE RD TOWARDS TAHUYA, LOT IS LOCATED ON WATER SIDE ; TOTALLY
EXCAVATED ; DEVOID OF ALL V,SGITATION; AND ADJACENT TO NORTH SHORE ROAD
PROJECT NOTES :
SEPA 94-116
TYPE AMOUNT BY DATE RECETP
PRMT $ 23 . 50 TLG 08/22/94 000
STFE $ 4 . 50 TLG 08/22/94 000 l
PLCK $ 9 . 50 TLG 08 /22/94 000 c
-c 3 9y TOTAL. 37 . 5
"..c_PP.NT, rev: aaJe?Js
REQUIRED
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
t
MIS
FDi (� (� �'? (? MASON COUNTY
,1 1y�. 1��1 L� �l LLANEOUS PERMIT APPLICATION
I; 26 W. Cedar/P.O. Box 186, Shelton, WA 98584 . 427-9670
PLEASE PRINT
hGiI
#1 Owner M-, (��-U>�n Phone# 2-0 VC Fire District# S>
CWe Address - n E 1 Z481 Y1Di� .-hole �! as d _City l�e� r w a 4 y52P
Mail Address A_8_ /2 4-21 At. S a-r-,-_ PZd
City St Zip qg S'z9
Applicant S` -e� 01 Ve h e 14-1.v a. yoe� Phone # Z c 4 Z7 5= q SS7 3
Applicant Address Ale- / SO /V c
City r4c f f'cu r St LU a Zip QQ Sz B
Directions to Site: /��z "��� mot'
GUd � C°.Ct U�-�t A UOId
a'r& a a c_ i,_- 4o �Uir-e_ e( .
#2 Parcel No. 3 2�3 5 - �1 - 0 O O
Legal Description of G o u+- [o+s 54--(o *--ay- * gr72 - C Az-"v j ra4 A- o�
map�t�- 11 2(o See e— <j 4A -U" -A-- 8 1 I S(e
#3 Indicate by circling the applicable source if any water is on or adjacent to the property site:
Csaltwa!er ake river creek stream pond wetland seasonal runoff marsh other
#4 Project Start Date Ac4 'A-P Project Completion Date to i '`t "S
#5 Use of Buildiing Describe proposed construction '7(c).C.�e_
L�:y 644 r--e.�vu VIR t Q a_." 5"` 11 / ;O` I c- (5
`Depending upon the type of permit,a floor plan and plot plan may be required.
'This permit is valid for 180 days from the date of issuance.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED CON-
MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR IN THE STATE OF WASHINGTON AND I AM
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE OF THE ORDINANCE REQUIREMENTS REGULAT-
ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND
IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DONE WILL BE IN CONFORMANCE THERE-
FORMANCE THERE\IVITH.NO CHANGES SHALL BE MADE WITH. NO CHANGES SHALL BE MADE WITHOUT FIRST
WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILD- OBTAIN ING-,APPROYAL F M THE BUILDING DEPART-
ING DEPARTMENT. MENT. I�
X OWNER X BY
DATE DATE
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Wells
Water Lines Shorelines
Drainage Plan Easements
Septic Systems Name of Fronting Street Indicate directional by
Proposed Improvements Name of Flanking Street
N S, E, W etc.
PLOT PLAN AREA
FOR OFFICIAL USE ONLY:Accepted by: Gate: �!
DEPARTMENTAL REVIEW
FOR OFFICIAL USE ONLY
Planning �, a - �� APP COND APP HOLD
�13
Building
Fire Marshal
Other
Special Conditions /570 Fees
Permit Fee $
Plan Check
Other
Other
State Building Fee c�
(2-E0 TOTAL DUE $ SO
APPROVED
M S BUILDING INSPECTOR
---_ GES SUBJECT TO APPROVAL
-."— •�
N C \
'/ '- � prc�p�skJ ��r+ccmtNtoF
ic6s�c4, � r u�ton+ QE�Y�wN4, Nr^i'
TY
p,,Nts S��Ctc�oj�
` 3�"10RE,04v �IpNN
; p q !
^ � �Fti-Srih IA(
�
IR !71Rs C-or\, 1� 13powN Tak...lo. vst&a --
1�1L I�'�_1 N StioaE Ra s�►6 r T�x Sr72-e ;� Reas�,w;h^wAt! tob� Atl 13rso 61 .%4ftre-
n++our iaAe� A spit 1126 'r�e2;N+d
Al y5',,KJ,� -1°Je-(�r, (l.�a Q4529
SEF S:HIVF� Sf/ISb '� CZeGI 1.-IS-VS`13
ri
r
f
APPROVED
A�, �'�;
t P P i OV E {���1liMEN! Up�AN� P�E�P\Nv�`I 7
MASON BUILDING INSPECTOR W�11 A5 �° P°���SS+�krdau� 6y
�� )ASaN mwvgSSFf `�\oaF�rv� plwMvftL
CHANGES SUBJECT TO APPROVAL
-....�_—_.._._____._._....v.._._.__._.. 30 0.41 E1cCPVA tE� �00'lirvh (`1A�i0.vA!
--DATE Tn b£ p� 04%jfien4Pae1 11
Svd£ of e-j cA,(gi•1pN a eKol f O
��w15'r, G1ta��� wvih v\Sc6u1hC urytil �f--Z«+
/ of wo, �S bokc""afJ
9�,�•~ REbPR sc1.E.du1� / N° k3c"MP+�18,I'to b£ uaj
�bMl
{b
eonepe�� s,ell be rn;p A sack
flew PIPN� MAX
C/T �CiIw2L�
II CotvcRE�E (�1k WPienlebE A t� to mix
+_ ^.�v'WgEl> KolES 1I � ONtM 1N AMOUN�s '�'a A��11 ttV
Arc kf.11 CoNifs'A oti iD 'irgif, All
f� �.��,?iL'PoU0.ou$ QAFJe�Iy MMEk\fl� piEA SuP.E Mth�S /a i• )eb S\��
\Kil v1 c 11.$ yy
14---aa•---tI �`5� 1
�v.l�h i Rac 3 �f Gov ��-ts s t,s
�TA'A 7 2- C t-v.a TRA r{ A o�
yA5 ?MIAs 4pi1 5P 0 {IzG
5tm- Surtvc $ 6
ls
P►0,093- si Vp IaN8 Rtd))"N'1N1c)J W A I, NC- 12y.21 AI 6hoRC fed
EAR, . BEI�q�� WAsh.
I
I
1
� {„, *�,�^�..- '' , � Jam\ ',j, !.� • t{3-�•a1f.
y
1
�a � 3sa � I �L'70