HomeMy WebLinkAboutSHX2024-00008 - SHX Application - 3/11/2024 * RECEIVED: RECEIVED
MASON COUNTY MAR 11 2024
COMMUNITY DEVELOPMENT 615 W. Alder Street
Permit Assistance Center,Building,Planning
PERMIT NO.: C�t .)(P'0 4-oo N�
SHORELINE EXEMPTION APPLICATION
Shoreline development in Mason County must conform with the Mason County Shoreline
Master Program. The program requires that substantial development (any development of
which the total cost or fair market value exceeds $8,504.00 or materially interferes with the
normal public use of the water or shorelines of the State) be reviewed with the goals, polices, and
performance standards established in the Master Program.
New or expanded docks or beach access structures will likely require a substantial development permit
instead of a shoreline exemption. Consult with a Mason County Planner.
APPLICANT: 1�4^�,(� c/
ADDRESS:
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(City) (state) (Zip)
PHO / 'J� 1 L EMAIL: I V t ✓yy11 'L III
AUTHORIZED REPRESENTATIVE:
ADDRESS:
(street)
(city) (state) (zip)
PHONE: EMAIL:
Answer all questions completely. Attach any additional information that may further describe
the proposed development. Incomplete application will be returned.
PROPERTY DESCRIPTION:
General location (include property address,water body and associated wetlands—identify the name of the shoreline):
Include all parcel numbers: Projects loca-fed in open water area, away from land shall provide latitude/longitude.
22.c:�'09 _UoaZ (,
Is the applicant the property owner? YES () NO
Owner:
(street) (city) (state) (zip)
Development proposal (identify and describe the proposed project, including the type of materials to be used,
construction methods, principle dimensions, and other pertinent information):
Existing Use (identify current use of property with exist improvements):
Reason for requesting development:
Estimated Fair Market Value of Project to Closest$1,000:
ACKNOWLEDGMENT:
I hereby declare, to the best of my knowledge and belief, the forgoing information and all attached information
is true aD
orrect.
(Applicant or Authorize epresentative) (date)