HomeMy WebLinkAboutBLD2023-01274 - BLD CD Environmental Health Review - 11/28/2023 • • Damsut •ten:ml5rasrsea+ea>e+s�ssesTlaaaecz
MASON COUNTY RRP"Em"�N°FF' V 4
COMMUNITYDEVELOgMl'1 T D '�1a7
Permit Assistance Center,Building,Planning 3
BUILDING PERMIT APPLIC "W Alder Street Z
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: G
NAME:NemMeamer NAME:em DlmanancammelNl = .�
MAU,NIGADDRESS:Wl EFagm Dbw Dr MAMING ADDRESS:715 Tam Ara Me stare 5 m O
CrN:swwMaw STATE:A ZIP:suft CTTY:TumaMar STATE:'A'A ZE:91101 a' Z
PHONE#l:> M-11a PHONE:360-8A. CELL: 38047 BM �►
PHONE n: EMAI.:Ia"'>a�mtlmalwp�newMln.mn
EMAIL:ba"ah)*Saaa`e�eot L&I REG#4THDOCaz50D p,7(p,_/_/_ = Z
PRLMARYCONTACT: OWNERD CONTRACTORD OTHER❑ 4
NAME uoMMwc.rra EMAIL NntleManmiM^alo^mmm Lo^
"LING ADDRESS 715 Tam Ara aulm 5 CIw STATE WAS ZIPsa6p1
PHONE ma'am'° CELL emnpra 2M
PARCEL INFORMATION: lSLrtl
PARCELNIR.IBER(IZDigit Numbaz)='M'M1 ZONINGRI+S IOV 182023
LEGALDESCEEION(AbbVa,Wd)SHORECRESTADDRFEwTWM11.0T:41 FIRE DISTRICT
SITE ADDEFS391 FaM 9M,Mme Ln CITYseMn RECEIVED
DIRECTIONS TO SITE ADDRESS"RA Tuna R an CnMNra Dr,Tom R on settee,d,Tom L on SMleMe 0 W,HMPM w10
ISTHEPROIECTWTTBIN3M° OFSLOPE(S)GRRATERTHANIRX: MD NOD WOWLOAD:_-Xd
IS PROPERTY WTTNN ZMFT OF THE FOLLOWING: IowAdt.b.q,.y/:
SALTWATER 0 LAKE❑ RIYOR/CREEK D POND❑ WETLAND❑ SRUSONAL RUNOFF 0 SCREAM
TYPE OF WORK: NEW❑ ADDITION 0 ALTERATION D REPAIR D OTHER ❑
USEOFSTRUCTURE(Araidmr.Cw ..gam,„ BUa,5felReaMMp
ISUSE: PRIMARYO SEASONAL❑ NEIBEROFBEDROOMSZ NUMBEROFBATHROOMS!
HEATEDSTRUCIFURE? 1iES0nh1,B EI YESOW11-01da)❑ NOD
DESCR®E WORKAMI°^�a'r^�
SOUAREE FOOTAGE:6a wre0
ISTFLOOR ITC sq.ft 3NDFLOOR ITC p.I 3RDFLOOR sq.ft EASEMENT K.R.
DECK—,A COVERED DECKp.ft STORAGE p.R. O[IER_pft
GARAGE p.ft AaaMhwD DeMMAeaD CARPORT sq R. AnachealD DeaoWD
MANUFACTURED HOME INFORMATION: ad COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUhEER
ENVIRONMENTAL HEALTH:
SEWAGEISFWERSOURCE: SEPTICB SEWERD / NEW❑ EJOSTRNGQ
PLUMBNG LN STRUCTURE? YES❑ NO E] IY} ,,attach w.,ateted Wager Adequery Form
PERIM1ffiTER/FOUNDATION DRANK PROPOSE)? YES O N00 EXISTING SQ.FT.
MSTNG BEDROOMS a PROPOSED BEDROOMS D TOTAL BEDROOMS 0
OWNER atlsowbtlpea met Maxweam aI Imcwrele InMmaM1m may mutt In a akp ra,k orEr or pmntl revttatlon.M hoetedaehnwe of acet te by
onothartartnes Eetlereel am IM•maranE N,IMrGec6ra Ne110m enWeE brecpw Nia pe,mN enE to Eo IM1e vvM a aporyaeE, tem
cdalnM pannts+lwi M1om all at rexaery Partin,I,MUCInp ho easammlM1 are ,erh or peNefMimeral,egaNLg mb phe ao Ttie awrero,bso e pel
and aW Aum(s)�valw aM mepecAon�it partnWapplicahon Oacanea hot 6 wbb wwkor aaumonoad mnaWNnah not wmmermE Beth 1W
Maya or n vn4,unbn rAM1 s tat,dea t«a peM]of 180 tlen.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTNfTY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
L 84 COUNTY CODE I6.°aAZ)
10/3/30i3
X
ER(Must Mstereo Me the OWNERI Data
ED:UA �kL REVIEW APPROVED DATE DENIED DATE TAGSINOTESICONDTEONS
PARTMENT
PARTMENT
LTH
EH setbacks
A.) Crawled requires a 2X minimum sef0ack to proposal addition with
WAI20244Hm30.Reserve requires a IOft aelea&to addition
\ S.)Septic tank(s)requires 5•setback from all footinglfountlations
S� Iry ��- with WAINo
wA
1Y� C.)Na fou eseries,area eter Drains within 30ft,tlowngratliant of
n Drainfiel Cut
Elamite)
area
D.) ,d Cut ranps)(greater Man a s over 45 degrees)within
SOX,down gradient of Drain' Reserve area
1• - ',. EH APPROVED
— Rhonda Thompson 04/18/2024
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No perimeter/foundation
a
drains on this addition
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