HomeMy WebLinkAboutRLC94-0779 - RLC Application - 4/18/1994 * Date Received: Z41 /✓lq*—
MASON COUNTY "vo
DEPARTMENT OF COMMUNITY DEVELOP ENT
qw RESOURCE LANDS AND CRITICAL AREAS CHEFKW� GE � VE APRThe following c eckli is designed to assist an applicant for a Building Permit, On-Site )W
Evaluation and Disposal Permit, Access Permit, Land Modification Permit, BIMNERALne �reeected
Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their prop y
regulations under the Mason County Interim Resource Ordinance (77-93)*. This checklist is an important
opportunity for identifying early in the permit process whether there will be any environmental regulations affecting
the proposed development.
Owner / Sh-tarqv Phone #p-66 )
Site Address Al L 0 K oj (.44 /14 Q k 61\1 City 90 fur, w(A. Zip y c?
Owner Address P, Ed City -t rQ r State t-x Zip d�-?-
Tax Parcel No. (Confirm with Assessors Office) /;;1 —3 a 1 - _- V e Legal Description_
900 ��
Project Description G1le:cr ee2_44-
Directions to site (Please attach map) fod UuT at' Ul, Hyw 3 luyi, L.' FT
Oti /Y _ Lv yar) r4 6 ' Lt F T 4 k T a Pro&iTY
Okk h UZ _ y H+k Trees
Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc.
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Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas
Official and resource lands are available for review at Mason County Department of Community Development, Planning
Use Only Department.
Do any of the following exist on this property or within 200 feet of this property?
Count Yes No
❑ 1. Saltwater shoreline or a lake 20 acres or larger?
❑ [R""� 2. Rivers, streams, or creeks with year-round flow?
/En ❑ La- 3. Rivers, streams or creeks with intermittent flow but are with a clearly defined channel?
❑ Lam" 4. Lakes or ponds less than 20 acres in size? Ao
104 ❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances
support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See County
Maps for guidance.) "
�❑ 6. Slopes greater than 15% (8.51 daegrees)? (See the County
Landslide
and Erosion Hazard Maps for
guidance.) i �0`'�D f?E�1r'A�.GL�' �4 0,gevt' /f/ '4/,
❑ [�/J 7. Floodplains? (See County Federal /Mergency Management Maps and County Seismic Hazard Map
for guidance.)
A] ❑ El 8. Seismic Hazard Areas? (S e County Federal Emergency Management Maps and County Seismic
Hazard Map for guidance.) `.
You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any
of th following programs:
coualty Yes o
❑ 1. Agricultural Open Space Taxation Program, RCW 84.33
/E] ❑ 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest,
RCW 84.34
I
' Copies are available at Mason County Department of Community Development for $5.00 each.
RESOURCE LANDS & CRITICAL AREAS
SITE PLAN
PLEASE SHOW THFJOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE:
► Location &dimensions of existing &proposed property boundaries. ► Approximate slope of land (grade &direction), topography.
► Identify legal access including,width of all road right-of-ways &easements. ► Location of significant natural features(water bodies, rivers).
► Locate all existing & proposed structures,drainfields, wells &driveways. P. Project description
Scale 1"= North Arrow
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s have answered e bove truthfully to the best of my knowledge.
Applicant/Owner �G yy Date
FOR OFFICIAL USE ONLY
Adjacent property.
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There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Mason
County Treasurer.
When completed, this form becomes part of the permit application.