HomeMy WebLinkAboutSPI2014-00059 Cancelled - SPI Application - 8/14/2014 SPI z6_1q- =5q
ACCEPTED BY`M5H
MASON COUNTY
PLANNING DEPT. PRE-INSPECTION APPLICATION
PLEASE PRINT $255.00 Fee Required
1. Site Address: '6 �tY � r e,�%ekLr
Owner: �!�U// Applicant:
Owner Address:
%,,' a �Q�,1 Applicant Address: /71
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City: <�c,, StZip City: St Zip 3
Phone: ('L-r 2 ) (�/`j - j day Phone: (3C,-L*)) day
Phone: evening Phone: (36o) �1 --,?c:)8 evening
Email A ress: Email Address:
2. Parcel Ws 17 2-5- - (jl Y")
Legal Description:
3. Purpose of Pre-Inspection: 1�I�t 5;i<'5 0%rv� /� �/G�-1 eOfAl
®/V Pld&e�& Al
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4. Use of building: � e -1 /�;WeWf->;.�'
5. Do any of the following exist on or adjacent to property?: slope ( saltwater(0/lake
pond ( ) wetland ( ) seasonal runoff O other O stream ( ) seasonal creek OaCiS�`fNc'- 5;�►��,�.. �,%
Directions to Site. //A tr' 37
/ I�Ieiq/Zot-lo�- es
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, P ni g Division
P.O. Box 279
Shelton, WA 98584
Please include a $255.00 check or money order payable to Mason County Treasurer.
MORE ON BACK SIDE
I:\Community Development\PAC\SPI\2012 Pre-Inspection.doc
I
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
ILLUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT.
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Departmental Review
(For Office Use Only)
Planning Department Findings:
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I:\Community Development\PAC\SPI\2012 Pre-Inspection.doc