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HomeMy WebLinkAboutMEP2023-00016 - MEP Application - 11/16/2023 ti d w� • MASON COUNTY Mason County Permit Center Use: COMMUNITY SERVICES MEP vZD - 000 1 aullding.Planning,Environmental Health,Community Health Date Rcvd 615 W.Alder St.—Bldg.8.Shelton,Wa 98584 Phone:(360)427-9670 ext.352 ♦ Fax:(360)427-7798 . MASON ENVIRONMENTAL.PERMIT(RISIDENTIAL):SI 15 HABITAT MANAGEMENT PLAN:S300 © MASON ENVIRONMENTAL PERMIT(NUN-RESIDENTIAL):S 1500 OCONDITIONAL USE: S2000 Mason County Resource Ordinance(Chapter 17.01 MCC) ENVIRONMENTAL PERMIT APPLICATION 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. PROPERTY ER Name: Mailing Address: oe Work Phone: Home/Cell Phone: Email Address: !1 M C 144 t-44 dvQ.! A e 1 an agent is actin or the property owner during the permit process, complete#2. 2.AUTHORIZED GE T Name: Mailing Address: Qv Work Phone: Home/Cell Phone: Email Address: 3. PROJECT SITE Site Address: Parcel#: 2 _ ! �� Legal Description: 122 Directions to Site: .3 44.� e Attach a site plan showing the following: Lot Dimensions,Flood Zones,Existing Structures,Fences, Water Lines,Driveways,Drainage Plans,Shorelines,Septic System,Topography,Proposed Improvements, Easements,North Arrow,and Scale.Also draw a separate topography diagram. Rev.August 2022 ronm"I LLC Arc-f os A 98584 Environ►rlenf'al LLC 3118 4. State which section requires permit: ❑ Long Term Commercial Forest,Chapter 8.52.060 ❑ Frequently Flooded Areas,Chapter 8.52.130 ❑ Mineral Resource Lands,Chapter 8.52.090 ❑ Geologically Hazardous Areas,Chapter 8.52.140 ❑ Critical Aquifer Recharge Area,Chapter 8.52.120 ❑ Seismic Hazard Areas,Chapter 8.52.150 ❑ Erosion Hazard Area,Chapter 8.52.160 1�- Fish&Wildlife Habitat Conservation Areas,Chapter ❑ In-Holding Lands,Chapter 8.52.070 8.52.170 ❑ Wetlands,Chapter 8.52.110 5. Identify current use of the property with existing improvements: / �I 2 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): 7. Describe why the action requiring this permit cannot be avoided. _T ^}� Ki'iC-Ante 8. Will there be an alteration of a wetland and/or wetland vegetation area(circle one)? Yes O No 9. Identify any surface water on or adjacent to property(circle one): Saltwater O Lake ® Stream O Pond © Wetland O Drainage Ditch O 10. Identify existing septic/sewer connection(circle one): If septic is located on project site,include records. Connected to SepticoConnected to Community Septic O Connected to Sewer None Existing© 11. Identify existing water supply(circle one): Public Water Supply Well 0 11.Type of Job(circle one): New Add O Alteration© Repair Demolition Other: Print Name ' Signature 4 Rev.August 2022