HomeMy WebLinkAboutSPI2015-00020 - SPI Application - 3/20/2015 RECEIVED
MAR 2 0 2015 SPz o�D15. 0ON,
426 W, CEDAR ST. MASON COUNTY ACCEPTED
PLANNING DEPT. PRE-INSPECTION APPLICATION
PLEASE PRINT $255.00 Fee Required
1. Site Address: \
Owner: p an n e. ay i eS Applicant: Son n l t Qay I e—S
Owner Address: `-P 0 &)X_ 4-3 Applicant Address: T' O f O k 433
City: geG Fa i ✓ St LLA zip q8 6219 City: BPJ F� r St QUA zip 665 29
Phone: (3(0C� 2-1 S—(a(p g 2 day Phone: (.40al 21S-(p to g'L day
Phone: (3(00 2-IS - (p(o g 2. evening Phone: (3 ) 215- (c(o g?- eve g .
Email Address:1On►'){e dayie5?�j�unb Email Address: _bonnif-CLayie _S .1('m•0ffn
2. Parcel#Is 1 2-30 � - 13 - CJ 06ey"
Legal Description:
3. Purpose of Pre-Inspection:
4. Use of building:
5. Do any of the following exist on or adjacent to property?: slope ( ) saltwater( ) lake 04) river ( )
pond ( ) wetland ( ) seasonal runoff( ) other( ) stream ( ) seasonal creek ( )
Directions to Site: TaVe, CA 00 &-ay CALL J) "A kd
Ti,rn I f+ q Glo(k3 rox . 2 rni1e-5 J To er MitSSi6n
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:y/ Date:_ C,
If you would like to be on site during inspection,please check here: (Y)
Return application to: Department of Community Development, Planning 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
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 ADEOUATE
ILLUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT.
Departmental Review
(For Office Use Only)
Planning Department Findings:
IACommunity DevelopmentTAC\SPI\2012 Pre-Inspection.doc
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