HomeMy WebLinkAboutBLD2015-00620 Final Pole Bldg DDR2016-0004 - BLD Permit / Conditions - 9/9/2016 Inspection Line(360)427-7262
Q5�c7 °paNTA MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III
426 W. Cedar
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT
BLD2015-00620
OWNER: GERALD SINGLETARY RECEIVED: 7/22/2015
CONTRACTOR: ALPHA STEEL BLDGS INC 800-854-4410 LICENSE: ALPHASB117PU EXP: 7/11/2017 ISSUED: 9/25/2015
SITEADDRESS: 863 NE OLD BELFAIR HWY BELFAIR EXPIRES: 3/25/2016
PARCEL NUMBER: 123204290032
LEGAL DESCRIPTION: TR 3-C OF NW SE EX TR C OF SP#153#303682
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW DETACHED POLE BLDG ST RT 3 TO BELFAIR, L ON ST RT 300, FOLLOW STRAIGHT ONTO OLD
BELFAIR HWY, FOLLOW TO SITE ADDRESS ON THE LEFT SIDE, SHARED
DRIVEWAY WITH 861
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: vb
Type of Use: SF Insp.Area: No.of Bathrooms: Occ. Group: u Lot Size: Deck:
Type of Work: ACC Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,440 Garage-Detached 1,440
Valuation: $ 61,776.00 Building Height: Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: N 25.0 Ft. Shoreline: Ft. Water Body: UNION RIVER
SEPA?: No
E 315
Model: Width: Ft. Rear: .0 Ft. Slope: Ft. Shoreline Desi
Side 1: 15.0 Ft. 9.: Rural
Year: Serial No.: Side 2: W 30.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Plan Check Fee GMM 7/22/2015 $473.04 S120150000000(
Address Fee GMM 7/22/2015 $ 173.50 S1201500000001
Planning Review Fee GMM 7/22/2015 $205.00 S120150000000i
Building Permit Fee SLC 9/21/2015 $727.75 S220150000000i
Building State Fee SLC 9/21/2015 $4.50 S220150000000(
Total $1,583.79
BLD2015-00620 Please refer to the following pages for conditions of this permit. Page 1 of 5
CASE NOTES FOR
BLD2015-00620
CONDITIONS FOR
BLD2015-00620
1) Approved per dimensions and setbacks on 07-22-2015 submitted site plan. Setbacks are measured from the furthest projection of the structure. The
building,site is to the west of the Union River floodplain area.
2) All nstruction and demolition debris must be removed from the site after project completion. Proper. is osal of construction debris must be on land in
such a manner that debris cannot enter or cause water quality degradation of State waters. X
3) Temporary erosion control measures must be implemented to prevent water quality degradation of Macent w er or properties. Silt fencing, straw, or
surface matting must be installed and maintained until upland vegetation has become established. X
4) Concrete I ate and wash water must be contained during construction pouring, such that water quality de adation of adjacent waters does not occur.
X
5) All property lines shall be clearly identified at the time of foundation inspection. X
6) Retaining walls needed to support a surchar-Qeuch s structures, roads, or to sup p slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X AN
7) By definition, propane tanks and heatpumps re structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure
these structures meet the setback conditions listed.
X
8) Landings and tairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approved Site Plan"t e sure hese structures are shown and meet the setback conditions listed.
X
9) Contractor registration aws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X
BLD2015-00620 Please refer to the following pages for conditions of this permit. Page 2 of 5
10) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
Dep nt rior to any further inspections being performed or approvals granted.
X
11) Own /Agen i esponsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
X
12) The plan revi check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal of appi %2cuments will result in failure of required building inspections.
X
13) This structure i pproved as unheated space.
To be considered unheated space the area may be provided with a heating system that does not exceed energy usage of 1 watt per sq. ft., or 3.4 Btu/h
per sq. ft. A permit and approval shall be required prior to installation of any heating system.
When a heating system exceeds 1 watt per sq. ft(or 3.4 btu/h per sq. ft)the heated space shall be insulated in accordance with the energy code in effect
at the time of permit application.
X
14) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then
approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Building Departrynt prior to any further inspections being performed or approvals granted.
X
15) WIND LOADS - oof coverings shall be designed and tested to withstand the maximum basic wind speed. The basic wind speed for Mason County is 85
MPH.
X
16) REQUIREMEN FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the
manufacturer's installation instructions.
A drip edge shall be provided at eaves and gables of shingle roofs. (IRC 2012 R905.2.8.5)
X N L -
17) Any changes in Uposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be
charged and shal aclollected by the Building Department prior to any further inspections being performed or approvals granted.
X
BLD2015-00620 Please refer to the following pages for conditions of this permit. Page 3 of 5
18) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
perm re oc tion.
X
19) CON RUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspecto h II be made prior to requesting additional inspections.
X
20) All prope lines shall be clearly identified at the time of foundation inspection. X
21) All permits expire 180 days after permit issuance, or 180 days after the last inspectio ctivity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have p ev nted action from being taken. No more than one extension may be granted.
X
22) All building pe its shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason County or in nces and building regulations.
X
23) Pressure treate od manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, and shin I stall metal connectors approved for contact with the new types of pressure treated material.
X
24) A Mason County Storm ter Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement,
inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the
owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel
prior to the commencement of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes
an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are
responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system
of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final inspection of
the building permit the owner/agent/contracto cknowledging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
BLD2015-00620 Please refer to the following pages for conditions of this permit. Page 4 of 5
OWNER/ BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by
signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the
work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s) for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if
construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
s o3�oj I'A'a'a
ig ature (^� Date D �Q OWNER - R RE ENTATIVE - CONTRACTOR
Print Name (Circle one to Indic te)
BLD2015-00620 Please refer to the following pages for conditions of this permit. Page 5 of 5
Alpha Steel Buildings, Inc.
1 724 Cole St., Ste. 10
I �riAt
IL
�. Enumclaw, WA 98022
1�ao��. 60lpAD 3GO-825-77G8
v RECE1 ♦ ED ALPNASB 1 17PU
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ALLSETBACKS ARE MEASUR
SITE PLA REQUIRED TO BE-D . SITE
i ROM THE FURTHEST CHAANSU
JECTTOAP V'AL
PRO CTION OF THE BUILDING By o ee 30 ,
4'
D V�!Y ,E D I T C H o
PL Singletary, Gerald Mary E.kVSitus: X NE Old Belfair Hwy, Belfair, WA 9,5528 (to be assigned)
Mail to: 729 30r:, Ave.
Seattle, WA 98122
Parcel: 123 20-4 2-9003 2
Legal Description: TK 3-C OF NW SE EX TR C OF SP #153 #303G82
K -
Surface Coverage: 3.9 1 Acres
Storm Water Management by means of gutters (2) and down spouts (4)
Proposed: I ,440 scl ft Garage
to splash blocks (4) in direction of flow, and in accordance with Mason County Storm Water
Proposed: 300 sq ft Access Management Plan currently in force.
Soil and Sedimentation Management by means of
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Nam Parcel # Q ??Ro L C'7 /�4��� BI.D# D��• ��v��
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Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Pcr Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development,or redevelopment',vrith more than 2,000 square feet of impervious surface2.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater. Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area *All dimensions in feet
Buildings - X = d
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections (example:
eaves/gutters)
X =
Driveways X
X — Length of drive begins at the right of way
X
Parking Areas X a R
X ar — Any paved, gravel or packed area per definition
above table
X =
Patios/Walks X =
X = Any paved, gravel or packed area per definition
above table
X =
Others X
X = If the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area (sum of all areas) i+4P
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please read, acknowledge and sign below.
Based Upon the information you have provided aStor►nwaterSkePlan IS NOT required for this development activity.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. 1 declare that 1 am the owner,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspection as may be required. N�y
X a�''�'l�J Owner/Agent/Contractor(circle one)Date: 0`
If th Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read, acknowledge and sign
the information provided on page 2 of 2.
n_,__ i _ram
L
Name Parcel# V �� LO ol)30 BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stornswater Site Plan IS Required for this development activity.
Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website:
hMLwww.co.mason.wa—us/code/Commissioners/index.htm
Please follow the links to "Title 14,Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70)_ You will receive a copy of the Public Works document
entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan". This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE BIWIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A ( The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason Countvs Public Works
Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT. 450
Mail: P 0 Box 1850, Shelton WA 98584
Physical: 415 N 6th St, Shelton WA 98584
I this development has, or will have,a septic/drainfield system you may need to contact Mason County Division of
Environmental health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other, parcel.You may also wish to consult with the septic design professional involved with the project. Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT. 352
Mail: P 0 Box 1666,Shelton WA 98584
Physical:426 W Cedar St,Shelton WA 98584
A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described rolpe�rt-y fo\r review and inspection as may be required.
X ���r t/{�.� /Q Owner/Agent/Contractor(circle one)Date: �/ ��
'BULDING
CO& MASON COUNTY
fi Permit No: I�0 261 15-DW20
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•FIRE MARSHAL (360)427-9670 Shelton ext. 352
http://www.co.mason.wa.us/community dev/ (360)275-4467 Belfair ext. 352
426 W Cedar Street, Shelton WA 98584 (360)482-5269 Elma Fxt. 352
BUILDING PERMIT APPLICATION j .
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:S 1 h �NAME: ,s4z c, t ' pm
MAILING AD SS. MAILING DRESS:
•
CITY:5V.0,*t STATE: W A ZIP: 12 CITY: ► d&&.)4TATE: , Z :c g
PHONE: CELL:c2D 0 a D $7, 68 PHONE:j(a-&'X5_ CELL:
EMAIL.: EMAIL 42�4. ,K& P
L&I REG#Wtp
ffXP.
CONTACT : OWNER❑ CONTRACTORA BELOW
❑
NAME: MAILING ADDRESS: 7� W 4 � ' '
CITY: STATE: WA ZIP: PHONE CELL:
EMAIL: . ( Tj yn 8
PARCEL INFORMATION: /�
PARCEL NUMBER(12 DIGIT NUMBER) ' �T 0,9 FIRE DISTRICLEGAL T
SITE ADDR SS � N(AB i CLUL-, CITY
VRECTIOIYS TQ SITE ADDRFSS
IS PROPERTY WITHIN 200 FT:
SALTWATER❑ LAKE❑ RIVER/CREEK POND ❑ WETLAND❑ SEASONAL RUN TREAM ❑
DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 1 ° NO �--
TYPE OF JOB: NEW [' ADDITION ❑ ALTERATION ❑ REPAIR FIANeR ❑� �o�
USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) F P,—
IS USE: PRIMARY❑' SEASONAL ❑ NUMBER OF BEDROOMS NUMBER�f OOMS
DESC E WORK
SQUARE FOOTAGE:
1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.
ft-GARAGE sq.ft. ATTACHED ❑ DETACHED ❑ CARPORT sq.ft. ATTACHED❑ DETACHED ❑
W FACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED
WMODEL YEAR LENGTH-
WIDTH BEDROOMS BATHS SERIAL NUMBER
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner or owner's legal representative. I further
declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the
necessary parties, including any easement holder or parties of interest regarding this project.The owner or legal
representative, represents that the information provided is accurate and grants employees of Mason County access to
the above described property and structure(s)for review and inspection. This permit/application becomes null &void if
work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of
180 days.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42)
W x 'yll�-' -V /
Signature of OWNER Date
DEPARTMENTAL REVIEW APPROVE DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT PLANNING DEPARTMENT
DEPARTMENT
FIRE MARSHAL
FEE'S TOTAL VALUATION:
BUILDING PERMIT FEE - FIRE ACCESS AND GRADE
PLAN REVIEW GEO-TECH REVIEW
PLUMBING&BASE FEE STORMWATER REVIEW , - . .
MECHANICAL `BASE FEE TOTAL FEES
WOOD/GAS/PLTLET STOVE VIOLATION INVESTIGATION FEE
PLANNING REVIEW FEE VIOLATION FEE
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a
P^R O �E D Alpha Steil Buildings,Inc.
/,d
F� t+ 1724 Cole St.,Ste. 10
MASON COUNTY GCO PL.,A10MNIr Enumclaw.WA 98022
SITE PLAN R QU11RED TO BE ON SITE 360-825-776,5
CHANGES SUBJECT TO APPHO AL I
r ` � At 17PU
PLAN LO LVISIO i' / By Date 6 Exp.7I1 ;12017 I'60�
R El
DATE ( - �- � �Co - - - -- -- E. ESMT(PVT)
P L 400'5v itsci W
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-- DCTCH LINE -
5mgletary,Gerald Mary E.
5itu5: )=NE Old BelPair Hwy,Belfair,WA 98528(to be assigned)
Mail to: 729 30"Ave.Seattlle.WA 98122
BLD2015-00620
Parcel: i 23201}2-90032 t I
Rewsed 1 2109/20 1 5 Legal Description:TR 3-C OF NW SE Ex TR C OF 5P#153#303682
Surface Coverage: 3.91 Acres
Proposed: 1.440 sq ft Garage `.storm Water Management by means of gutters(2)and down spouts(4)
to splash blocks(4)in direction of flow,and in accordance with Mason County Storm Water
Management Plan currently in force.
5o,l and Sedimentation Managm eent by means of
silt fencing around perimeter of proposed footprint,if required by Mason County.
'r
MASON COUNTY Mason County Permit Center Use
DEPARTT\4 NT OF COM- MUNJTY DEVELOPMENT DDR 20 I LP
411 AT.Fifth Street/P.O.Box 279,Sbelton WA 98584
360.427.9670 ext.352 Date Rcvd 20 I �p
Request for
Administrative Variance for Reduction in the Required Setbacks($115.00)
For administrative review,the minimum variance on a setback request is 5 feet from the side yard lot
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the fin-chest projection of the structure
including roof eaves and gutters.
Applicant/Owners: I n C4 VAYI YJ
Mailing Address: 7 d`� kZ tf>
City: State: �(�. Zip: g8ta a
-EMM& M ve__h5
If this reduction is tied to a building permit,please give permit case number.
BLD le) I jp;16
Parcel Number(s): 1 a 3 a(L - `4 oA - _ Zoning _ _
Site Address: ��'�✓ -� ��d. 1 ,
Requested setback variance:
Q_^ft 'Front ❑ Rear ❑ Side
ft ❑ Front - ❑ Rear ❑ Side
ft. ❑ Front ❑ Rear ❑ Side
ft ❑ Front ❑ Rear ❑ Side
Front Setbacks-From access easements and road right of ways. Minimum 10 feet.
Rear Setbacks-From the rear property line. Minimum 10 feet.
Side,Setbacks-From the side property Iine. Minimum 5 feet except for certain shoreline desioanations.
An illustrated site plan is required.
Your site plan must show the follauing: north avow,abutting street or easements,set backs to all
property lines and existing buildings,slopes, surface water,wetlands, critical areas, septic,well and
driveway. Show all proposed new development.
G � r
Ya--�, • o�1 � am ��iYl/La� ����J
A-P F r
4-pyry-
T AND OR REAR YARD REDUCTION R.E UESTS:
FRONT _
For existing lots of record as of March 5, 2002;
You must meet one of the foUowing:
1) One of the following exists on the lot(check all tba apply):
❑ a) steep slopes,wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-fourth acre;
'Zi�e) existing improvements of buildings,septic systems,and well areas.
.-------
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5,2002;
You must meet one of the following: =
2) One of the following exists on the lot (check all that apply):
❑ a) steep slopes,wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-half acre;
❑ e) existing.improvements of buildings, septic systems, and .well areas.
Explain how these circumstances preclude a r-- sonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
ALIO V
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Aw hAd'--, i-l'o 6t" " S s , N • Pitt-�C_ —
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C�No� I'L -
P 4'-V Q,il• ;Q-c dam/
Owner/ genf lease indicate
i a e Date
Official Us e Only t
fApproved by: Date l r O
Denied by. ._ __ Date
Reason for denial:
i