HomeMy WebLinkAboutBLD2024-00816 - BLD CD Environmental Health Review - 7/10/2024 MASON COUNTY Permit No: ZOWq#"t b140
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Center,Buildln ,Planning JUL 0 9 2024 R7
BUILDING PERMIT APPLICATION 615 W. Alder Steet <
PROPERTY OWNyE�R�INFORMATION, CONTRACTOR INFORMATION:
NAM@�IW'YIOSH 1.�Y ppP1TYJ/NpR4 I'1111L1iE
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MAR, GADDRESS: 4s MAIL GADDRESS: D Z
CIFY STATE: �'LI-P; cm,: _STATE 21P f—
PHONE#I: PHONE: CELL: "' T.
PHONE k2: EMAIL: _ TT1
EMAIL: L&1 REGM PDIP._/_/_ Z
PRIM BY TA OWNERq cONTRAcrDR❑ OTHER
NAME EMAIL{�Y1pL�O.IT�IfY r
NAMING ADE ESS
PHONE �1
PARCEL INFORMATION:
PARCELNUMBER(12IX®c Numbn) IZ'� 1-S(�-Q r� ZONING 7
LEOALDESCRIPI'fON(ANucv®ro0d nl-(.¢ ISPI' YY�C YV.� f FIRE DIBTRICT y SITE ADDRESS l d
CTTY
IItEC'I'IONS TO ITEA DRESS
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ISTBBPROdECTWlT 300F1OFSLOPE(S) TERTHANI4K: YES[] NO�SNOWLOAU:�yzr
ISPROPERTYWPF 200FTOFTHEFOLLOWINC: f['Mienfmrcyylyl:
SALTWATER[] LAKE[] RWER/CREEK❑ PONDD WETLAND❑ SEASONAL RUNOFF[I STREAM❑
TYPE OF WORK: NEW' ADDDTON❑ ALTERATION❑ REPAIR❑ OTHER rl
USE OF STRULTNN6(pu;am...u.oec ram PNe.a ) Q 1 alri..P,r � hIYTYL$..
ISUSE: PNTMARYjj SEASONAL❑ NUMBEROFBEDROOMS J NUMBER OF BATHROOALS
HEATED STRUCfUR YES In2d.euy� YES rra.Y+l of ❑ NO❑
DESCRIBE WORK
SQUARE FOOTAGE:rv,we,:n
ISTFLOOR14 sq 42 .ft 2NDFLOORI1NIe1l�
Lsq.ft 3RDFIAORNf14 s ft. BASEMENT Iffisi ,R
DECK sq.ft COVEREDDECK N.ft STORAGE RI.ft OTHER—N.R.
GARAGE��aq.R AnaMa1❑ Daarhed❑ CARPORT sq.ft. Auarhed❑ Derarhed❑
MANUFACTURED HOME INFORMATTON: V COPIES OF THE FLOOR PLAN REQUIRED-
MAKE qfLhA YXn6i MODEL 7 i(e3 6 YEAR Iff24 �-LrEVN2GTH SW
WIDTFI _BEDROOMS BATHS_`sERW.NUMBER I IJD
ENVIRONMENT I.HEALTH: -
SEWAGFISEWERSOURCE: SEPTIC SEWER❑ / NEW❑ MaSTING�
PLUMBING W STRUCTURE? YESV NO❑ qye, M ah cvaa,l WarerAdrq,form
PERIMETERTOUNDATION DRAINS PROPOSED? YES[] Nayy EKISTINCSQ.FT.
E)USTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWXER aWbNWaea Na eWnbEbn d Fmlam iRmnatlm mrymsuYM a ppp xak w�ra pennll nvaration.XMnwAetlaement of coal b b)
¢gnalure pyov.l O¢dnre NY em Neawraa—I NNrereany tlull L e ,,cmann—Mb cea¢II aae btlofM1avMazpmgsetl.l M1ave
OEleinae pumb¢iM 4pn alltic rece%ary paeieS.MCIuyn9 anY eaumenl lwNci o,paeiec of roman.regaNig Nic 11-1 TM ovmerc�le�l
an,lM m(s Wasm6Ndlnsa wmalpn pryvieN baccwalcdN gare¢emplcyeex of Ma¢on Couetty eec¢yeb Me aaove eeaCnbetl pm
eM¢WJareca)Ip Rviawane ivspxYon ml¢peimNeppllfJlian le¢ane¢hall a WN a walk d eulMn:ea wnclracllon m M wmrneccM W�m
mys m e masmcpm won<b¢uaneee mr a peeoe a f ro p.ya
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF HIS DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.06.42)
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S4 M O (W ucl ha.Inng W ft OWNER, Delp
DEPARTM®V'l'AL REVIEW APPROVED DATE DENIED DATE TAGSMOTF4/CONDITIONS
BUB,DMGDEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBTSCHEALTH
RECORD DRAWING (Required)
CHECKLIST PLN SETBACKS
12 Drainfied& PLN Approved Front(swp.25'
manifold orientation 0713112024 Sides:20' -
&layout vason County commissary Dewebpmem Rea,.10'
Gavin S tham
�I Trench/bed All Changes Subteat to Apgwal 'all setbacks measured Rom the forth
dimensions and projection of the building
critical diStanCas -subject to EH setbacks
within layout
a Septic pump tank
placement
fl Location ofS-
buildings '—
�o
observation port&
clean-out location _
'$ Location of wells&
roads FXtS•F++< -
Undisturbed natve t�
soil between
trenches
)8. North arrow
Porch may only be within 2 It of b
transport line if the porch is on pier 2 to
pads or blocks. In-ground footings N
must be no less than 2 ft rom 3
I
transport line (4,13 y,tip (,1 eAz
/ v�
q71 eeo sc.
eNOT AN APPROVED SEPTIC DESIGN-
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EH SETBACKS
A)Drainfield liheeme requires 10'setback from boting/foundations
B)Septic tanks)requires 5'setback from all fooungifoundations
QNo foundabor/perimeter draim within 30'dawn-gradient of drainfieli EH APPROVED
re erve area
D)No cuts),banks)(greaser than 5 &ower45 degrees)within 50' a.aeevwn 0801
down-gradient of dralnfield/reserve area
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