HomeMy WebLinkAboutMEP2008-00042 multi-parcel - MEP Application - 5/29/2008 H -T 2 no
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PERMIT NO.:
MASON COUNTY DATE RECEIVED:
DEPARTMENT OF COMMUNITY DEVELOPMENT
RESOURCE ORDINANCE (Chapter 17.01 MCC)
411 N. 5TH Street/ P.O. Box 279, Shelton, WA 98584
ENVIRONMENTAL PERMIT APPLICATION
MASON ENVIRONMENTAL PERMIT El' CONDITIONAL USE ❑
The purpose of the Resource Ordinance is to protect Mason County's natural resource lands and critical
areas and is under the authority of Chapters 36.32, 36.70A, 39.34, 58.17, 76.09, 84.33, 84.34 and 90.58
RCW.
PLEASE PRINT
1.
Owner: 41A ,04 /7 f;� je49 R 6 A ell Owner Mailing Address:
Site Address:
X �( X f S a4 L Z7 VA ti City: /l" VA State:4./A Zi F5Y�
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City: L L —/V State G✓,A Zip:975_2 Lien/Title Holder
Phone: Daytime(.?60 ) 2 7 7 — 3
Address: ez? Aox ?,Z9
Fire District#:
City: State: wA
Signature:
2. Parcel Number: f oZ 2 0 1/C7eg Legal description:
/ Z220 — Sv -- ySo/ U
Parcel Size: 3 3 A ex,, A / L k y d T h--9
A'Loc-,r
3. Directions to site: A &.c/,eJ
State what sections require a permit: In-Holding Lands, Chapter 17.01.062 ❑
4' Long-Term Commercial Forest, Chapter 17.10.060 ❑ Wetlands, Chapter 17.01.070 R'
Mineral Resource Lands, Chapter 17.01.066 ❑ Frequently Flooded Areas, Chapter 17.01.090 ❑
Aquifer Recharge Areas,Chapter 17.01.080 ❑ Landslide Hazard Areas, Chapter 17.01.100 ❑
Erosion Hazard Areas, Chapter 17.01.104 ❑ Seismic Hazard Areas, Chapter 17.01.102 ❑
Fish and Wildlife Habitat Conservation Areas, Chapter 17.01.110 Ww'_
5.
Identify current use of property with existing improvements:
Z 2 2 d — F tvepa ,lrq p c� 7-
2 6? Sr7 ^ �}S_o/ o e% e4427
6.
Identify and describe the proposed project,including the type of materials to be used,construction methods,principle
dimensions and other pertinent information(Attach additional sheets if
needed): ''p L O L O 0! 0AI 4257'-J�
7.
Will there be an alteration of a wetland and/or wetland vegetation area? Yes ❑ No J9
8. Any water on or adjacent to property: 04VO f
Saltwater ❑ Lake 0 River ❑ Pond ❑ Wetland ❑ Seasonal Runoff ❑
Other
9. If septic is located on project site,include records. '0V® �
Connect to septic? ❑ Community Septic? ❑ Public Water Supply? ❑ Well? 0
10.
Type of Job: New ❑ Add ❑ Alt ❑ Repair ❑ Demolition Other
This permit is granted pursuant to the Resource Ordinance(Chapter 17.01 MCC)and nothing in this permit
shall excuse the applicant from compliance with any other federal, state, or local statutes, ordinances, or
regulations applicable to this project, but not inconsistent with the Resource Ordinance. The permit may be
rescinded pursuant to the event the permittee fails to comply with the conditions of this ordinance.
MASON ENVIRONMENTAL PERMIT: $560.00/$335.00(with another permit)
MASON CONDITIONAL USE ENVIR.PERMIT: $1,350.00
HABITAT MANAGEMENT PLAN: $395.00
IAPLANNIMC&MENVIRO►VMENTAL REVISED 01-16-07
Show the following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Water Lines Driveways
Drainage Plans Shorelines
Septic System Topography Indicate Directional by(N,S,E,W,etc.)
Proposed Improvements Easements In relation to plot plan
Name if Flanking Street
APPLICANT TO DRAW SITE PLAN BELOW:
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APPLICANT TO DRAW TOPOGRAPHY BELOW:
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MASON COUNTY RESOURCE ORDINANCE July 2003
Publication cost is the responsibility of the applicant. Final permit processing will not occur until
advertising fees have been paid to the newspaper by the applicant. The Shelton-Mason County Journal
will bill the applicant directly.
I /WE understand that I /WE must sign and date the attached acknowledgment indicating and that I /
WE understand that is MY/OUR responsibility. I /WE must submit the signed page as part of
application in order for it to be considered as complete.
c'
DATE
OWNER
APPLICANT
May 29' 2008
To whom it may concern:
Subject: Signature authorization .
I am Harold Carey and I own the following properties:
Parcel# 12217-43-90020, 12217-43-90030
12220-50-0025002,12220-50-26001,
12220-50-27002, 12220-50-27004, 12220-50-27005,
12220-50-44008, 12220-50-45010, 12220-50-55001,
12220-50-55004, 12220-50-55006.
1 am authorizing Jeff Carey, my son, to sign whatever documents are necessary to remove
the trees from these properties.
I understand a least two documents that need to be signed are Mason County's "Mason
Environmental Permit" application and the Forest Practices Application.
Thank ou.
8
r�
Harold Carey
P.O.Box 330
Tahuya, WA 98588
360-277-3454
he@harold-carey.com