HomeMy WebLinkAboutMEP2010-00004 - MEP Application - 4/1/2010 PERMIT NO.: M EP 20 10 — C0004
DATE RECEIVED:
MASON COUNTY UCEIVM
DEPARTMENT OF COMMUNITY DEVELOPMENT
RESOURCE ORDINANCE (Chapter 17.01 MCC) APR 0 1 2010
411 N. 5TH Street/ P.O. Box 279, Shelton, WA 98584
MASON COUNTY
ENVIRONMENTAL PERMIT APPLICATION
MASON ENVIRONMENTAL PERMITA CONDITIONAL USE ❑
The purpose of the 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
1.Owner: Of4v 1 o Qy�- l
� Owner Mailing Address:
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Site Address: `` l 7 g i e. .)tA� j o City: slle-1 �0 0 State: W*. Zip%9.5 e y
City:0N l 0 ba State Wj� Zip: Lien/Title Holder
Phone: Daytime( C) ) yqo A q q2_
Address:
Fire District#:
City: State: Zip:
Signature:
2. Parcel Number: - 35'3 - Od(D 10 Legal description: (Z
Parcel Size: 3 5, )) q
3. Directions to site: (1
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State what sections require a permit: In-Holding Lands, Chapter 17.01.062 . ❑
4. Long-Term Commercial Forest, Chapter 17.10.060 11 Wetlands, Chapter 17.01.070 ❑
Mineral Resource Lands, Chapter 17.01.066 ❑ Frequently Flooded Areas, Chapter 17.01.090 0
Aquifer Recharge Areas, Chapter 17.01.080 ❑ Landslide Hazard Areas, Chapter 17.01.100 ❑
Erosion Hazard Areas, Chapter 17.01.104 ❑ Seismic Hazard Areas, Chapter 17.01.102 0
Fish and Wildlife Habitat Conservation Areas, Chapter 17.01.110
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5.
Identify current use of property with existing improvements:
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6.
Identify and describe the proposed project, including the type of materials to be used,construction methods, principle
dimensions and other pertinent information(Attach additional sheets if ,
needed): lox Z rt c rc �a e 'o>J �... i 1
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7.
Will there bean alteration of a wetland and/or wetland vegetation area? Yes ❑ No
8. Any water on or adjacent to property:
Saltwater^ Lake ❑ River ❑ Pond ❑ Wetland ❑ Seasonal Runoff ❑
Other
g. If septic is located on project site, include records.
Connect to septic?00community Septic? ❑ Public Water Supply? ❑ Well? ❑
Sp.�v}c��ieccs rds �. t4 f-l-I9�-h.ec�
10.
Type of Job: New X Add ❑ Alt ❑ Repair ❑ Demolition ❑ Other
This permit is granted pursuant to the 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 Resource Ordinance. The permit may be
rescinded pursuant to the event the permittee fails to comply with the conditions of this ordinance.
MASON ENVIRONMENTAL PERMIT: $630.00/ 388. (with another permit)
MASON CONDITIONAL USE ENVIR. PERMIT: $1,520.00
HABITAT MANAGEMENT PLAN: $445.00
1 APLANN ING\CMEN V IRONMENTAL
I
Show the following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Water Lines Driveways
Drainage Plans Shorelines
Septic System Topography Indicate Directional by(N,S,E,W,etc.)
Proposed Improvements Easements In relation to plot plan
Name if Flanking Street
APPLICANT TO DRAW SITE PLAN BELOW:
APPLICANT TO DRAW TOPOGRAPHY BELOW:
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