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HomeMy WebLinkAboutGRD93-00020 - GRD Permit / Conditions - 7/6/1993 MASON COUNTY PERMIT NULL PERMIT BY EXPIRATION Mason County Bldg. III 426 W. Cedar DATE 9 BY \ P.O. Box 186 Shelton, Washington 98584 I'Iri } : IOEi Ii1}llt�l `,'� Nt 121 1.01 YAP$) kD tit-t VA F.R til.Ira[ N AI I kN SF1f Attt K i'I)NI11A1. € oR : OWNER l -, U)NlkAt 10k 1:N1,1.N1-� FIt f A k I A (iHAI I- tt I })[ '-,Ch I I i I tlN fJ ++ilia Nii (it fil.AY i ANI'I I s;tf 0:1' i, !fok t;t 111 I I't kM l I fit 14011 '10411 `vfr} Ii 1 I- Wijk1 ft;- ft:1 � 1 tii t I i,i•t riff 1 t},�t< I . I It t I,Itf i f f,hit't¢ tit 1 1) I"..t i 1 Ii 1 0 I C.0N:'; } tti)1 I t 0 H ON 1,10 t. I t" I tIhIM}I.`.III" i I1 I- v101 Mf i_ 11t I "NII MIA I I11F-I Lit 1-101,1" } 1 Ifd .1 if 4 ; alit ill IiI ' f+ ; fit i :tf.a llc9`i i i . (II„NU Ij irt+ AW N I {.�•k��1\ �. �t"�..� � '�� � .k �'�1� siii f t 00 FkAi, rPv lA�tlt�4! CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date by Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING Attic OTHER Groundwork date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by aA.JUN COUNTY LAND MODIFICATION PERMIT Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner l . Phone# Site Address Lit _City St�Z Z . " %S' Owner Address •�. �3 ,,� 7�'9 C1ty .Cf, St Zip-2zL", Describe Work �.«�!w To � ,� � Sf'oc Q #2 Contractor Name __Z!5//e0 l'-1 .S,( 4ee � T,(' Contractor Reg# ' , � Address_ r)Oe- 6,),e '7,,P i Expiration date . qz Ci ty Z?-' StL Zip 2s;2x? _Phone .1 G( #3 Engineer's Name f�E> f -r Phone# Address Ci ty St Zip__ #4 Parcel No. lco Legal Description C' �- L S. #5 Number of cubic yards to be excavated: a -? UCDG� Number of cubic yards to be filled: 1 of©c L Munber of cubic yards to be graded: U #6 Will this be a balanced cut and fill entirely within the site? Yes No If NO: Will fill be brought on site? Yes -�— No Where does imported fill originate from? ���,-fi�^�• .11�., a ���,p Does fill contain any potentially hazardous materials? Yes No #7 Will excavated materials be taken off site? Yes No If Yes: Where will excavated materials be taken? ,q #8 Briefly describe existing terrain, vegetation, and improvements on subject site? ! r .� �- c�c;1,�, t, S /�r��� S :tea -741'L� .� 09 Has a soils report been completed on the subjec site? -so ,o& Cw-4p- If yes, include copy with application. 5'o,,,�cQ #2 0 Does the subject si to co zn any of the follow(((i((( ng features? River Lake �. � Wetlands / Slope grea ter than 15-t /v compressible Sal it ter Soft compressible soils Seasonal Runoff �( ;,_ None E11 Will the proposed land surface modification change the points where storm crater or groundwater enters or exits the site? V6 112 Will the proposed land surface modification change the quality, quantity, or velocity of storm water/groundwater? , Brie S=3ect site within 200 feet of a designated shoreline? / () #14 Whaf rM- Ods, if any, will be utilized to mi ze rosion an Possible sedimentation into nearby waters? ! �� f � !„ C L.t,�,v� r" mac. PS #15 Will this land modification result in the redirection of any surface water. runoff onto adjacent properties? #16 Wi1lra2r-face or subsurface runoff be collected or controlled by interceptors, curtain drains, or other water collection devi es once this land modification has been completed? 2 _N #17 Will the land be replanted upon completion? C'.r, If yes, with what types of plants? #18 what are 7 the engths�aad height of s1 o es currently existing on the site. #19 Will this modif.154tion result in slopes steeper than those currently on the site? _ V.9 _ If so, how steep? Show following on the site plan Directions to job site Lot Dimensions Flood Zones Existing Structures Fences �, ;,y W✓ytGy E>f �� u, ,/ 3 Structure Setbacks Driveways T Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Name of Flanking Street Name of Fronting Street LDa cale:te: l o7as niaoua T.HavaDodo, mvdc of INvoI'Idd'd, orIas Nvid szls Mirxa os .I.tmr --- �-:ul.Ll P4UL-Li A.vL VUll) lF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENUn OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR CCNTRACTORS REGISTRATION LAW RCW 18.Z7 , AND AM AWARE IN THE STATE OF UASHINGTON AND I AM AWARE OF THE OF THE MASON GOUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS RE GULATING THE WORK FOR WHI CH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY �/ u. DATE lc - ��'r�7 DATE -2,2-- 3 Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 FOR OFFICIAL USE ONLY Accepted by Date _. ..xi DEPARTNMNTAL REVIEW FOR OFFICE USE ONLY Approved Coed Hold Approval Planning: \ l� Ii I !,i iEnvironmental Health: 5 IBuilding Plan Review: Fire Marshall: i ,;� Other: i ne s r/N -�,k THESE PLANS MUST BE ON THE JOB SITE ,r- e w' FOR INSPECTION. /'OBE 5 r � 10 H M -440 3 ° 33 v U , 2 C>VA PC-ooj\--. r`a.35 0� tnay LAIN .moo i--+� N 5 ('��IG.✓ZT 51+� it u1 4L bG.(eS cL ,1 be N ctD JO o N �ppL ul C of ml Z4 !� c 7,A CHANGES o� SUBMIT CHANGES FOR APPROVAL PRIOR TO PERFORMING WORK APP80V'ED MASON BUILDING INSPECTOR JHANGES S TO APPROVAL '�g cl t o, Z ata o � � �' el - i v N y O 4N � � r 400, .g i, W s s 0o a' - 1 .E Z •GZ ,Li i i ,Lb ` boz \ L ��y ,Lb o�_ t J p ,6b M ,«, '99 � � dZr��! 5 i -4 5 Z o� ► b 62 s ,S I \ grog oFE SGZ 09b g2Z �91 0� sS a� 5 07 I � MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,Washington 98584 (206)427-9670 BUILDING PARKS& RECREATION FAIR/CONVENTION CENTER ADMINISTRATION December 20, 1994 Allen M. Shearer PO Box 789 Belfair, WA 98528 RE: GRD93-0020 Dear Mr. Shearer, In response to your request for clarification on the above issued permit, our office has reviewed the property file for parcel no.: 12321 -42-00060. The Land Modification permit and SEPA review was for a total of 50,000 cu yd, the permit application indicates that 27,000 c.y. would be excavated material on site and another 23,000 c.y. was to be imported although the Environmental Checklist submitted to the Department of Community Development shows that 22,000 c.y. would be material on site and 28,000 c.y. would be imported material, so there is a discrepancy that needs to be addressed relating to the amount of imported fill. The Land Modification application states on question number seven (7) that the excavated materials would not be taken off site, at present time this appears to be in question as it is not consistent with the DNR Surface Mine Reclamation Permit Application which is presently pending and with the activities presently occurring on site. Question number six (6) on the Land Modification application asks if the imported fill contains any "potentially" hazardous materials, to which the question was answered no. The information provided to this department regarding your recent proposal to accept imported fill from Kitsap County makes notation of "low level cadium" content. A determination from the Mason County Environmental Health Dept., Solid Waste Division, stating that this would not be considered "potentially hazardous material" would need to be submitted to this department prior to the commencement of fill being brought on site to verify compliance to this statement however, prior to even that, the Environmental Checklist prepared by yourself which was submitted to the Department of Community Development and utilized to issue the Determination of Nonsignificance for the approval of GRD93-0020 needs to be modified to show the source is other than what was named on the SEPA checklist. The SEPA checklist on Page 3 shows that the fill material to be brought on site was to come from J & S Ent. Gravel Pit. Page 1 of 2 The DNR Environmental Checklist on record with our department on Page eight (8e) states that 50,000 cubic yards of material will be proposed and in indicating the source of the fill, on that application you answered, " 50,000 yards fill, mostly on site, some from a local gravel pit", which is consistent with the answer given in the SEPA checklist provided to the Department of Community Development. Any fill coming from any other source not listed on the SEPA checklist could be deemed in violation of the DNS which was issued. I would suggest that you contact the Department of Community Development to resolve this situation. Until these conflicting issues have been clarified and resolved, the records show that the fill must come from mostly on site and secondly, from the gravel pit listed pursuant to the SEPA checklist and DNS issuance. Again, please contact the Department of Community Development prior to commencing with any activity which may be deemed contradictory with the original approval of the Land Modification Permit by the Department of Community Development. Since ly, ` mi Griffey Building Inspector cc: Property File Mike Byrne, Building Official Mike Tokos, Environmental Health Department, Solid Waste Division Don Brush, Department of Community Development Page 2 of 2 Building Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location � � This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance J ?J D�� psi c� L✓G�i� %�,T�f.� / ''►'�OC�i�T/yG` %"/�-�- /��9 T'C/�//�C S �C!'Y C��/-T/_= You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection Department ,C,.? -� Date Inspector 7W moos NUT ► nM « *V T Imeh, T A AA I jen CL Gee _ boy i -e • r� ,%l !�/� ��� III 111�II II Illli 111 �11111�II�,� � ® /'�� = .- .� -) ;,�:{w,?,w� r .. • , � `ky� 'o chi ,I�I , III:;!;'�I III II III �� � I' i �!��I�•I'���,i Illll, :�Ilil � , �� I►Ili, , � � a.l I � I�,� ' ,� � „�.�! r1!��fll►II ► I � I .I .� , _ 111111 I ..I ,IIIII ► III I III II II I ,I /� �' � . . 1►. � �IIU ►III II' '�i � � � n� �;;��� : �E �/ � � ��, .ie I .a � ICI � _ •�� . ; ;�'•' � �� �• !• I .-111••�11�.III`IIII, I I,!,•�': 1 I .�. � � _ In ' Illlll,:�lll�llli.�lll r _ `.���� .�' • ' � ,I I . III •.�� .� lil��II Illllllll;ill �I � •� � ��i � � ►111r�:,11,.�,� I�.I.i, . . , II III!!, � r �- � - ail�lll I illI I � I ✓I c•':a.�%i•�i. ;fir. 1 A►11 Pro f]eAt� rrIL,4 bL e.--lk-cl6k i�e�1 b��« ��ror� -rz� work lc coins 2�( THESE PLANS MUST SE ON THE JOB SITE —" 3 b FOR INSPECTION. Sit lc �'r :"too' '10 in 44� M OK-GUrN iC- 111 c -er'La\ rvx"4 b� � �okcv��ia� ('e(YIDt�� +r'or� Gn 3 P 33° h ; 7.� hc.y s (,Y\icl slope a 4lhlo bi[ .s d..c31 1A h�rnlc ' '^ IA cX-l- -61c) GS �b�e 340 - �Ik \\O kVe_ -30 ul • - 5Q � o� v�c�����orY, s�ck� z4 2; �- CHANGES c- .A SLi"R CHANGES'Pon APPROVAL PRIG' '() PERFORMING WORK -flOVED i'if�180M BUILDDIG IHSPECTori �L'^ tFZO I , ` I c A rccs&u " T TO APPAoVAL I °, atoZ� i N cut - 400, Case summary for Case No. : GRD93-0020 Date: 04/17/00 RADING PERMIT :GRD93-0020 : PROJECT:GRADING # : 5896 : MASTER:GRD93-0020 : NAME . . . . . :ALLEN M SHEARER STAT:C 10/22/97 LLH SITE ADDRESS :NE121 LOG YARD RD BELFAIR PROJECT DESCRIPTION GRADING PROJECT LOCATION SW CORNER OF HWY 3 AND LOG YARD ROAD BELFAIR FILL? . :Y: GRADE? :Y: STARTING DATE: / / SHORELINE DESIG. . . . . . . :N: CUT? . . : ? : ENDING DATE. . . / / STAFF. . . . . . . . : ? AREA GRADED: 50000 : : ? RCCAPO DESIG'. . . . . . . . : ? : DEC'N DATE. . . . . : 08/06/93 : VOLUME. . . . . . 50000 : cy SEPA. . . . . . . . . . . . . . . . :Y: EXPIRES . . . . . . . . : 02/02/94 : INSPECTION AREA. . : 0 : NOTES Memo field #1 -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- GRADING Memo field #2 -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- SW CORNER OF HWY 3 AND LOG YARD ROAD BELFAIR Memo field #3 -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- None - - - - - - Case summary report completed - - - - - - Page No. 1 CASE HISTORY FOR CASE NO.: GRD93-0020 ALLEN M SHEARER NE121 LOG YARD RD BELFAIR 04/17/00 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ------- ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- --- GRDA010 Application received / / / / 07/06/93 07/06/93 KS GRDA100 Building review 08/06/93 / / 07/20/93 DONE LAW 08/06/93 OF GRDA110 Planning review 07/21/93 / / 08/06/93 DONE JEM 08/06/93 OF GRDA500 (F) Issue permit / / / / 08/06/93 DONE FVC 08/06/93 FVC GRDA510 (F) Reprint permit / / / / 08/26/93 DONE FVC 08/26/93 FVC GRDA560 Permit cancelled / / / / 10/22/97 expired EXP LLH 10/22/97 LLH GRDA650 File Possession / / / / 07/19/93 TO JASON'S DESK AS PER REQUESTED. KS DONE KS 07/19/93 KS 071993 GRDA920 Miscellaneous action / / / / 12/16/94 received info that fill will come from TLG 12/16/94 TLG PSNS. After reviewing file, discrepancies in grading permit and DNR reclamation plan are questionable but at present time, activity on site is in compliance with the permit issued by us. Mike Tokos notified Al Shearer that if he brings anymore than 23,000 on site, because 27,000 is already there, than he will need to revise GRD permit. He also spoke with DNR. Mike T is to add memo regarding conversations into property file GRDA920 Miscellaneous action / / / / 01/17/95 Received letter from Steve Brittner on DB 01/17/95 DMB 1/12/95. Letter states that fill material will be from a local gravel pit and from J and S Enterprises gravel pit and from several construction sites. They understand that potentially hazardous material will not be acceptable under this review. We consider the changes minor in nature and not affective of the environmental review conducted in 1993. This action is approved as of 1/17/94. DB I 5/6/2008 Case Activity Listing 10:23:39AM Case#: GRD93-00020 Assigned Done Activity Description Date I Date 2 Date 3 hold Disp To By Updated Updated By GRDA010 Application received 7/6/1993 None KS 7/6/1993 KS GRDA650 File Possession 7/19/1993 None DONE KS 7/19/1993 KS TO JASON S DESK AS PER REQUESTED.KS 071993 GRDA100 Building review 8/6/1993 7/20/1993 None DONE DF 8/6/1993 DF GRDA500 (F)Issue permit 8/6/1993 None DONE FVC 8/6/1993 FVC GRDA1 10 Planning review 7/21/1993 8/6/1993 None DONE DF 8/6/1993 DF GRDA510 (F)Reprint permit 8/26/1993 None DONE FVC 8/26/1993 FVC GRDA920 Miscellaneous action 12/16/1994 None TLG 12/16/1994 TLG received info that fill will come from PSNS. After reviewing file,discrepancies in grading permit and DNR reclamation plan are questionable but at present time,activity on site is in compliance with the permit issued by us. Mike Tokos notified Al Shearer that if he brings anymore than 23,000 on site,because 27,000 is already there,than he will need to revise GRD permit. He also spoke with DNR. Mike T is to add memo regarding conversations into property file GRDA920 Miscellaneous action 1/17/1995 None DMB 1/17/1995 DMB Received letter from Steve Brittner on 1/12/95. Letter states that fill material will be from a local gravel pit and from J and S Enterprises gravel pit and from several construction sites. They understand that potentially hazardous material will not be acceptable under this review.We consider the changes minor in nature and not affective of the environmental review conducted in 1993. This action is approved as of 1/17/94. DB GRDA560 Permit cancelled 10/22/1997 None EXP LLH 10/22/1997 LLH expired Page 1 of 2 CaseActivity..rpt Case Activityg 10:23:39AM Listing s/39AM Case#: GRD93-00020 i Assigned Done Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By GRDA910 Meeting 4,26/2000 None PEND DWH 4/26/2000 DWH Meeting with Allen Borden,Andrea Unger,Allyn Shear and Dana Herron. While a building inspecter did not inspect the project,according to Allyn Borden(DCD)he was on site often since the beginning of this project. Ibis permit may be reinstated providing the following is reviewed and approved. I.Submit a revised SEPA and revised plan 2.Alyn Borden to document that he was on site on a regular bases.3. Revised plan to be reviewed by Public Works Applicaint to submit information by May 1, 2000 Page 2 of 2 CaseActivity-rpt 123219499999 �" - 123211300000. h 23217500020 F 123217500030 P.r6l),19PM --o0020 ". p"oI 123211400040 s 123211390051 O J ltzy 70 NE KATCHEMAK �/ �l' S' 123211390052 � cL p 123211400041 320 di e T23NRlW f_ �/ 1 Qun 123217500010 ,, ol 3at } 123214200070 ?8o 123214200060 110 9,Q O ao 123214200080 4r 25241 NE STATE ROUTE 3 ► 123219999999,0 • /123Z�14;300130- ?t1a2E:3;2=14 200090 s1 23214100�0 00a►• �I T u�� - oo-vot r� Case Activity Listing 3/19/2008 10:17:51AM Case#: GRD93-00020 t� Assigned Done Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By GRDA010 Application received 7/6/1993 None KS 7/6/1993 KS GRDA650 File Possession 7/19/1993 None DONE KS 7/19/1993 KS TO JASONS DESK AS PER REQUESTED.KS 071993 GRDA100 Building review 8/6/1993 7/20/1993 None DONE DF 8/6/1993 DF GRDA500 (F)Issue permit 8/6/1993 None DONE FVC 8/6/1993 FVC GRDA110 Planning review 7/21/1993 8/6/1993 None DONE DF 8/6/1993 DF GRDA510 (F)Reprint permit 8/26/1993 None DONE FVC 8/26/1993 FVC GRDA920 Miscellaneous action 12/16/1994 None TLG 12/16/1994 TLG received info that fill will come from PSNS. After reviewing file,discrepancies in grading permit and DNR reclamation plan are questionable but at present time,activity on site is in compliance with the permit issued by us. Mike Tokos notified Al Shearer that if he brings anymore than 23,000 on site,because 27,000 is already there,than he will need to revise GRD permit. He also spoke with DNR. Mike T is to add memo regarding conversations into property file GRDA920 Miscellaneous action 1/17/1995 None DMB 1/17/1995 DMB Received letter from Steve Brittner on 1/12/95. Letter states that fill material will be from a local gravel pit and from J and S Enterprises gravel pit and from several construction sites They understand that potentially hazardous material will not be acceptable under this review.We consider the changes minor in nature and not affective of the environmental review conducted in 1993. This action is approved as of 1/17/94. DB GRDA560 Permit cancelled 10/22/1997 None EXP LLH 10/22/1997 LLH expired Page 1 of 2 CaseActivity-rpt Case ActivityListing3/19/2008 10:17:51AM Case#: GRD93-00020 lip, Ef x GRDA910 Meeting 4/26/2000 None PEND DWH 4/26/2000 DWH Meeting with Allen Borden,Andrea Unger,Allyn Shear and Dana Herron. While a building inspecter did not inspect the project,according to Allyn Borden(DCD)he was on site often since the beginning of this project.This permit may be reinstated providing the following is reviewed and approved. 1.Submit a revised SEPA and revised plan 2.Alyn Borden to document that he was on site on a regular bases.3. Revised plan to be reviewed by Public Works Applicaint to submit information by May 1, 2000 • Page 2 of 2 CaseActivi t i MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,Washington 98584 (206)427-9670 BUILDING PARKS& RECREATION FAIR/CONVENTION CENTER ADMINISTRATION December 20, 1994 Allen M. Shearer PO Box 789 Belfair, WA 98528 RE: GRD93-0020 Dear Mr. Shearer, In response to your request for clarification on the above issued permit, our office has reviewed the property file for parcel no.: 1 2321 -42-00060. The Land Modification permit and SEPA review was for a total of 50,000 cu yd, the permit application indicates that 27,000 c.y. would be excavated material on site and another 23,000 c.y. was to be imported although the Environmental Checklist submitted to the Department of Community Development shows that 22,000 c.y. would be material on site and 28,000 c.y. would be imported material, so there is a discrepancy that needs to be addressed relating to the amount of imported fill. The Land Modification application states on question number seven (7) that the excavated materials would not be taken off site, at present time this appears to be in question as it is not consistent with the DNR Surface Mine Reclamation Permit Application which is presently pending and with the activities presently occurring on site. Question number six (6) on the Land Modification application asks if the imported fill contains any "potentially" hazardous materials, to which the question was answered no. The information provided to this department regarding your recent proposal to accept imported fill from Kitsap County makes notation of "low level cadium" content. A determination from the Mason County Environmental Health Dept., Solid Waste Division, stating that this would not be considered "potentially hazardous material" would need to be submitted to this department prior to the commencement of fill being brought on site to verify compliance to this statement however, prior to even that, the Environmental Checklist prepared by yourself which was submitted to the Department of Community Development and utilized to issue the Determination of Nonsignificance for the approval of GRD93-0020 needs to be modified to show the source is other than what was named on the SEPA checklist. The SEPA checklist on Page 3 shows that the fill material to be brought on site was to come from J & S Ent. Gravel Pit. Page 1 of 2 The DNR Environmental Checklist on record with our department on Page eight (8e) states that 50,000 cubic yards of material will be proposed and in indicating the source of the fill, on that application you answered, " 50,000 yards fill, mostly on site, some from a local gravel pit", which is consistent with the answer given in the SEPA checklist provided to the Department of Community Development. Any fill coming from any other source not listed on the SEPA checklist could be deemed in violation of the DNS which was issued. I would suggest that you contact the Department of Community Development to resolve this situation. Until these conflicting issues have been clarified and resolved, the records show that the fill must come from mostly on site and secondly, from the gravel pit listed pursuant to the SEPA checklist and DNS issuance. Again, please contact the Department of Community Development prior to commencing with any activity which may be deemed contradictory with the original approval of the Land Modification Permit by the Department of Community Development. Since ly, ` mi Griffey Building Inspector cc: Property File Mike Byrne, Building Official Mike Tokos, Environmental Health Department, Solid Waste Division Don Brush, Department of Community Development Page 2 of 2 LAND MODIFICATION PERMIT` Department of General Services 426 W. Cedar/P:O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 A- PEASE PRINT #1 Owner / r Phone# --,�676 7:5-� Site Address k)c- s ,a p_� '•! City S t a Y te Zi (�a� lJ_ Owner Address -�7Ci ty_2, /,�'�; StZip 9. Describe Work .-�,� —o �� _ 6, r / a �e , #2 Contractor Name A-111//e N J1! 20 d t-e t T1' Contractor Reg# ,3- Address �'C�. ,(�,, . '» ,n Expiration date ? .Z Ci St4*14 Zip Phone #3 Engineer's Name�e � Phone# Address Ci ty St Zip #4 Parcel No. �tco ' 1 Legal Description (� 4- L S #5 Number of cubic yards to be excavated: —?, 0DO Number of cubic yards to be filled: 5y,y0 U g Number of cubic yards to be raded: �, #6 Will this be a balanced cut and fill entirely within the site? Yes No _1/1 _ If No: Will fill be brought on site? Yes ---X_ No Where does imported fill originate from? �� Does fill contain any potentially hazardous materials? Yes No _�__ #7 Will excavated materials be taken off site? Yes No If Yes: Where will excavated materials be taken? �I #8 Briefly describe 'sting terrain, vegetation, and improvements o subject site? (�; #9 Has a soils report p been completed on the subjec site? .So ��S �u � If yes, include copy with application. 5•`,,,�cQ �(r",ue l w��{ 5�,� #10 Does the subject site co. in any of the following features? Ra ver —�=_._ Lake ¢ /1� Wetlands - /f� Sal twa ter 1� Slope Brea ter than 15. 0 Soft compressible soils A-10_ Seasonal Runoff .) None ' - #11 Wi11 the proposed land surface modification change the points where storm water or groundwater enters or exits the site? V6 #12 Will the proposed land surface modification change the ality, quantity, or velocity of storm wa ter/groundwa ter? AUTHORIZ�,U 1S NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OP. WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COM ENC,ED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLT REGISTERED CONTRACTOR CONTRACTORS REGISTRATION LAN RCN 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE OF THE MASON G"" ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN THE PERMIT 1S ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE G ,:�.-� `1 DATE .,z t3 '> 3 Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 FOR OFFICIAL USE ONLY Accepted by ' Date. U EPAR AL REVIEW �'n x FOR OFFICE USE ONLY +AM;r*ved Cond Mold Approval Planning: i Environmental Health: Building Plan Review: Fire Marshall: Other: 1 9 3 + s _-did � 75 - 3 5<6s ��� � tc�-sir-c,� � 6 dvrT c�-� U�-��� a � a 0�� � �� � , � �� �