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Home My WebLink AboutGRD2019-00009 Cancelled - GRD Application - 9/10/2019 rgoN OODN MASON COUNTY PERMIT NO. i -D�� DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 - Mason County Bldg. 8, (360)275-4467 Belfair ext.352 W4 615 W.Alder Street, Shelton,WA 98584 (360)482-5269 Elma ext. RE C E IV E D LAND MODIFICATION PE (Grading Permit) SEP 10 2019 OWNER INFORMATION: O AAMV INFORMATION INFORMATIONro 15 W. Alder Str et NAME: PCI, LLC - POC: Dean Mauerman Not se d yet. MAILING ADDRESS: 1415 College St.SE L D S: CITY: Lacey STATE: WA ZI 9850 C STATE: ZIP: PHONE: 360-280-0784 CELL: PH CELL: EMAIL: EM &I G# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBE e-ss-000� I FIRE DISTRICT NMRFA LEGAL DESCRIPTION(ABBREVIATED SITE ADDRESS None ITY Belfair DIRECTIONS TO SITE ADD m -3, r ton GVoARc&TrftI600 ft, turn North on Roy Boad Rd. Parcel is 1/3 mile up Roy Bo d her avem t turnsk lrakk IS PROPERTY WITHIN 2 T: e, nd determin\' \TL re usl bmitted to Mason County. — -SALTWATER❑ -LAKE - - RE ❑ PO - - - SEASONAL RUNOFF❑ STREAM ❑ — DOESPROPE VE 0 ) IN 300 FT OECT- REATER THAN 14% YES[ NO ❑ WILL TIMBE BE CUT A S D PARCEL PREPARATION? YES ® NO ❑ TYPE OF JOB EXCAV TION [ FILLING ❑x GRADING ® CUTTING ® OTHER ❑ TOTAL SIZE OF PAR L 1 .0 Acres ACRES/SQ FT SIZE OF AREA TO BE EFFECTED 4.5 Acres ACRES/SQ FT ESTIMATED AMOUN CUBIC YARDS 3000 CU Yards DOES THE SITE HAVE SLOPES 14%OR GREATER YES© NO❑ DESCRIBE SCOPE OF WORK Remove trees and stumps on the lower 4.5 acres of the parcel. Move 3000 yrd of material from E side Roy Boad Rd to the W side of Roy Boad Rd The slopes>15%will not be affected WILL FILL BE BROUGHT ON SITE? IF YES,SITE ADDRESS: No WILL EXCAVATED MATERIAL BETAKEN OFF SITE?IF YES,SITE ADDRESS: No DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES ❑ NO HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES[g NO❑ WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES ❑ NO[J WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES ❑ NO WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES ❑ NON WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES ® NO❑ WILL THE LAND BE REPLANTED UPON COMPLETION? YES❑ NO WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES ❑ NO IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES ❑ NO[J 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 INSPECJtON. INACTIVITY OF THIS PERMtT APPLICATION OF 180 DAYS WILL INVALIDATE THE A TLICATION. Si atur of Applicant Date IV 0 X Greg Mauerman for PCI, LLC OWNER IRFPRESENTATIVE71ONTRACTOR Print Name ATE)