HomeMy WebLinkAboutRLC94-0960 Cancelled - RLC Application - 7/31/1996 Al
Date Received: FIA19
MASON COUNTY
EPARTMENT OF COMMUNITY DEVELO RIM Q n�
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NWIN"ESOURCE LANDS AND CRITICAL AREAS CH I R 2 8 19o,4
The following checklist is designed to assist an applicant for a Building Per@L74Njf!R to J ��a,� e System Site
Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary in A`d F4nts, Land
Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by
regulations under the Mason County Interim Resource Ordinance (77-93J*. This checklist is an important
opportunity for identifying early in the permit process whether there willbe any environmental regulations affecting
the proposed development. 'KY-,
Owner 4 X AU 0 A 9 u O K) Phone #Llk ),..0 '7S-S�/T_
Site Address t3-fGGI # C i ty S r/-7'41`e— Zip 1
Owner Address allm F_ City State Zip
Tax Parcel No. (Confirm with Assessors Office)J43_1 - Z-- 90o SILK Legal Description
NE SOO
Project Description
Directions to site (Please attach map)
v-
I a e provide or attach vici t fnap ich includes cross streets, major roads, creeks, etc.
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Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas
Official and resource lands are available for review at Mason County Department of Community Development, Planning
use ONY Department.
Do any of the following exist on this property or within 200 feet of this property?
County Yes No
❑ ❑ PU 1. Saltwater shoreline or a lake 20 acres or larger?
❑ ❑ P 2. Rivers, streams, or creeks with year-round flow? �/lJ
❑ ❑ P 3. Rivers, streams or creeks with intermittent flow but are within a clearly defined channel?
❑ ❑ ( 4. Lakes or ponds less than 20 acres in size?
❑ ❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances
support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See County
Maps for guidance.)
❑ ❑ 0 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for
guidance.) 3 , �" ' "
0 L] 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map
for guidance.) 010
❑ ❑ 8. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seismic
Hazard Map for guidance.) "f
You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any
of the following programs:
County Yes No
❑ D 1. Agricultural Open Space Taxation Program, RCW 84.33
❑ ❑ Q 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest,
RCW 84.34
' Copies are available at Mason County Department of Community Development for $5.00 each.
RESOURCE LANDS & CRITICAL AREAS
SITE PLAN
PLEASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE:
P. Location &dimensions of existing & proposed property boundaries. ► Approximate slope of land (grade &direction), topography.
► Identify legal access Including,width of all road right-of-ways &easements. ► Location of significant natural features(water bodies, rivers).
► Locate all existing &proposed structures,drainfields, wells &driveways. ► Project description
Scale 1"= <.' North Arrow
state that I have answered the above truthfully to the best of my knowledge.
Applicant/Owner Date
FOR OFFICIAL USE ONLY
Adjacent property � `��
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Using County Resource Land Maps, this propetty iS deMohated as:
.:.;: 9, Long-term Commorc"aE )rAre5t 4. Shoreline Master I�rofjrar�t
l I 2. nho din Land
g 5. Does not apply.
Mineral Resource Land
r
Date l D CD
There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Mason
County Treasurer.
When completed, this form becomes part of the permit application.