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Home My WebLink AboutBLD Letters / Memos - 8/21/2008 INVESTIGATION REPORT FORM Revised 11114/06 Case Number: LV( W��g Parcel# �- - 0 1 1 1 0 - -� Violation Site Address: t-{o -�s E L! H l -v Property Owner(s): Telephone: 2'7S- o`� Mailing Address: �t col F.l N �tS t l �FtD� "��t t A t R i��+'tIt 5 r k 0CAtr OccupanTa to or Operator: Complainant Name: Telephone:(31 oycat - 3L( ` Complainant Address: S o C o F� A-((R !� �E LT--/t V `4) Location of Concern/Directions to Site: �fl -�JSfl �I� ice- L F>J L=`2 L)M 1 Dt. 1l1 V cl�z. 1)6C n ! -t ( (M-w c�-- � � rv�� Qc�� ;��1 n st6rJ �{ NCB-- � �•T�1J'� s ��, Po 0 i3 Lf uJ 1 u� G _ . �r1 1 L P o-4 4 U-T t t r 1E , �1 Ek�.0 S� �tt�i E,2 f' �1{� 2 U• u1 Si) �t r�t✓� Nature of Concern: ( yWE VJa,S Fi.etj)t� 'puRt +PCs LN NbLC,1Lb CAA-1 M,10) '-tom= E•EA b !�ul hA vu A6- D 2,tl n 1- -=two z NAs- FEECc n� 'i tJ o� tS Te-cU`r0 WE '-to szFT G rl Cc�1 cEn-I� e'7 t7��7 ttit A-, T s (LUc N iZ ALLY w-r 1 2L �� P L r l�l E�b r A n1' b 5CP\J -—A J -��(t cT,c t4 CQ na Department of Concern: wilding ❑EH Septic .-❑EH Solid ❑Planning ❑Fire ❑Public Works (For Official Use Only Beyond This Point) Received By: CAS 061 stir? S Date: Referred To: Date: Investigation Date and Findings: .f Resolution: L.k I &0dY Name: Date: 1 MASON COUNTY PUBLIC RECORDS REQUEST FORM 426 W Cedar St, PO BOX 186,Shelton WA 98584 PHONE (360) 427-9670 FAX(360) 427-7798 Please allow 5 business days for us to respond to your request' 'if items are being mailed please allow an additional 3 days until you receive the paperwork I would like the information: Requestor's Name 4r' 11"Veo Mail , Faxed Picked Up ❑ Address PD f3o X �5 Date of Request S Z-f—O7 City r St Zip Time of Request ry') Phone 3�� 7S��6T Fax PLEASE PROVIDE RECORDS FOR THE FO OWING: 1 2-3 -),0 Septic Records ❑ As-Built Only 12 Digit Tax Parcel No. 070 Other (See Below) ❑ - _ _ - _ _ _ _ _ Present Owner Legal Description Previous Owner cal Site Address � � ),4c5llo��. Please specifically describe what records or kinds of records you are requesting: c • RCW 42.56. I certify that the information obtained through this request will not be used for commercial purposes. Signature Date • Large requests may be charged as provided by RCW 42.56. During file review, any pages you with to have copied (excluding non-public record documents) must be tagged and charges will be assessed at .15 cents per page. Copies can be mailed or you may pick them up when ready. • Copies of blue prints or other large format items, when available, may be charged a higher rate per page Official Use Only Request Routed To: PAC File Clerk ❑ County Admin. ❑ Clerk of the Comm. ❑ Other ❑ Building ❑ Planning ❑ Environmental Health ❑ Public Works ❑ Assessor ❑ Auditor ❑ Treasurer ❑ Completed by: Ir'r - Ext Records were Completed date: j -Z`l 07 Faxed Notes: Mailed ❑ To be picked up ❑ Mason County Map Output Page Page 1 of 2 Mason County Ma ----- -- -- NE COURTNEY CREEK LN_ V` i Q) l 01 070 NE KRISTLANA WAY Z m 0 w fii pit p f r DISCLAIMER AND LIMITATION OF LIABILITY: The data used to make this map have been tested for accuracy,and every effort has been made to ensure that these data are timely, accurate and reliable. However, Mason County makes no guarantee or warranty to its accuracy as to labeling,dimensions,or placement or LEGEND location of any map features contained herein.The boundaries r,, P0e05 Federal Lands depicted by these data are approximate,and are not necessarily accurate to surveying or engineering standards,and are intended for �/MIgtw+ays city of Shelton informational purposes only.Mason County does not assume any ,Rivers 6 Streams county Bounaary(oNa) legal liability or responsibility arising from the use of this map in a cammrssioner DWricts manner not intended by Mason County.In no event shall Mason 41 County be liable for direct, indirect,incidental,consequential,special, _; Sections Lakes or tort damages of any kind, including,but not limited to,loss of TOWnsh" PUget Sound a Major Lakes anticipated profits or benefits arising from use of or reliance on the information contained herein http://mapmason.co.mason.wa.us/servlet/com.esri.esrimap.Esrimap?ServiceName=amason... 8/28/2008