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HomeMy WebLinkAboutSPI2024-00069 - SPI Application - 7/10/2024 �Ae°K c MASON COUNTY PERMIT NO. DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASOMWAMS (360)427-9670 Shelton ext.352 615 W.Alder St-Bldg#8 (360)275-4467 Belfair ext.352 1854 Shelton,WA 98584 (360)482-5269 Elma ext.352 PRE-INSPECTION APPLICATION $80.00 Fee required prior to Inspection #1. Owner Cg -r- 8,0Ai3,QRA CLnE2 Daytime Phone# 3>60- Site Address 1990 E, LAKE Lex-,P RD. City 5 HEL?o,J Mailing Address 201 CCfZT S f-I rLL rZ tb City CHC St OA Zip 11�9 53-"- Applicant GRC-(,olly &LDCK Address AD 9 C u tZrz s 1-lX C fZ D. City C f--1 EH'q St Pn_)A #2. Parcel No. [12 digits]: Q,�L,O o_S - S 3 - O O O 6 8 Legal Description: PHre-'-LTPs L4 1-4 r DX(/ y T2 68 #3. Purpose of Pre-Inspection r - r r OF ( xR2 1�CG oil t Laly� #4. Use of Building #S. Indicate by circling the applicable source if any water is on or adjacent to subject property: • Saltwater Lake• Stream• Marsh• River• Pond•Wetland• Seasonal Runoff• Other #6. Directions to Site: .Holz!H cs J 5T. RT, '3 . TZttZ.-) i2rGNT O.t) f�ZLY-FR2'AX_1 RD. , 73k" r-r-iT oy 21-1ze-c-X75 LA KC kD, . 7-Lt2J LL�_FT o.() PLL L:41R L-r4 kG LonP t2D-_T© 3_72_ r'1DI)2ESS 6,y 7/-tr- P_zC Jq 7- :5z o c. Show following on the site plan below: Lot Dimensions,Existing Structures, Structure Setbacks,Water Lines,Septic Systems, Flood Zones,Wells, Shorelines,Easements,Name of Flanking&Frontage Streets. AJ Indicate direction by N,S,E,W,etc JIM Cr <r 0. 14 p Y w�� C C)RT r w Ay / %C0 J O 1 � Applicant Signature- T Date: -7 ' /0 " al -9el ier Sf�C" 4�� �v I:\CommunityDevelopment\Alder-Updated Forms\Building Pre-inspection request-Alder [Rev:]an 20191 FOR OFFICIAL USE ONLY: Accepted By: Date: Receipt No. Referred To: FOR OFFICIAL USE ONLY Propos<1I proposal App eld Denied Plamiing: Building: Fire Marshal: Special Conditions 1:\CommunityDevelopment\Alder-Updated Forms\Building Pre-inspection request-Alder [Rev:Jan 20191 RECEIVED MASON COUNTY SPI Zo2y - OOC) o09 COMMUNITY SERVICES JUL 0 9 2U14 Building,Flaming Environmental Health,Community Health 615 W.Alder St.—Bldg.8,Shelton,WA 98584 61 9V. KWSteet Cq A V i t Q Phone:(360)427-9670 ext.352♦Fax:(360)427-7798 PLEASE PRINT $300.00 FEE REQUIRED PLANNING DEPT. PRE-INSPECTION APPLICATION Note:Pre-inspection does not survey lot lines and can only provide very general septic and water adequacy information. 1. Owner:QQ�a0%ty + BARSARA sr-i-MR. —'"— ) Applicant: Site Address: 1$0110 B. PHILLIPS I Arse t_P. t2D• Applicant Address: Owner Address: 2oq CVAr15 HILL AD. City: St Zip City: CHE14ALIS St WA Zip 98532 Phone:( day Phone:(3too) 719 . 3-7-72 Email Address: Email: �(jSL0ERLl96%PS_A)L. 00M (if different than applicant) Legal Description: 2. Parcel No. 22QQr - - Ono l048 Parcel No. - - 3. Purpose of Pre-Inspection: DETER A.)I - etn/ M VCH OE! LnT t s ButLDAAL.V_-. AND SET BACK FROM LA 14 . 4. Use of building: R651DENrtAL 5. Do any of the following exist on or adjacent to property?: slope saltwater ) lake river ) pond( ) wetland seasonal runoff( other( stream seasonal creek Directions to Site: 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:.. Date: ` 12y If you would like to be on site during inspection,please check here: Return application to: Mason County Community Services,Planning Division 615 W.Alder Street Shelton,WA 98584 (360)427-9670 ext.352 Please include a$300.00 check or money order payable to Mason County Treasurer When completed,this form becomes part of the parcel file. FOR OFFICE USE ONLY:Accepted by: Date: MORE ON BACK SIDE Rev. April 2021 tt 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 ADEQUATE ILUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT. Departmental Review (For Office Use Only) Planning Department Findings: