HomeMy WebLinkAboutSPI2021-00037 - SPI Application - 2/23/2021 • / MASON COUNTY VI
COMMUNITY SER �ENED
Building,Planning,Environmental Health,Community Health
615 W.Alder St.-Bldg.8,Shelton,Wa 98584 MAR 01 2021 SPi -
Phone:(360)427-9670 ext.352 ♦ Fax:(360)427-7798
PLEASE PRINT tree $300.00 FEE REQUIRED
PLANNING DEPT. PRE6ECTM APPLICATION
1. Owner: Paul 4 Sk&W^ Saline Applicant: C� w K e-A,-S
Site Address: 9311 E. Sfode- Q{o- /Ole Applicant Address:
Owner Address: /a-v City: St Zip
City: St WA Zip '1 Phone:( ) day
Phone:(.;;lo(v ) -i - ? (SI&ww-e-cJ ay Etnail:
Phone:(gp(o ) /J-(.y3 k*, evening
�oL SSo-`90 s-�Pac,lccll> Planner:12'jn'�
SMP Comp.Plan Type of Use
2. Parcel No.
3 ) 7 3 Ss / D O 603 Water Body
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Parcel No. - n -
Legal Description: ✓'oC.
3. Purpose of Pre-Inspection:A44-1 '4 tr'e-g 'yir we^6 tb Y�I�
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4. Use of building:
5. Do any of the following exist on or adjacent to property?: slope () saltwater W lake river
pond( ) wetland ) seasonal runoff( ) other ) stream( ) seasonal creek
Directions to Site: - 1 rr.i f=. e> iff Id-t-rb ma V'-csor4 _
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 la_ s regulating development of the site change after the time of inspection.
Applicant Signature t;-O"' �— Date:
IJ'wu would like to be on site during inspection,please check here:
Return application to: Mason County Community Services, Olanning Division
615 W. Alder Street
Shelton, WA 98584
(360)427-9670 ext. 352
Please include a $300.00 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
Rev.August 2017
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Please illustrate below the proposed building site in relation to critical areas (slopes, streams, lakes, wetlands,
etc.) existing improvements, as well as property lines. APPLICATIONS SUBMITTED WITHOUT
ADEQUATE ILUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE
APPLICANT.
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Departmental Review
(For Office Use Only)
Planning Department Findings: