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HomeMy WebLinkAboutRLC94-0527 - RLC Application - 4/7/1994 Date Received: > ' I �/ l/ • MASON COUNTY so DEPARTMENT OF COMMUNITY DEVELOPMENT RESOURCE LANDS AND CRITICAL AREAS CHECKLIST The /lowing checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Site Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Land Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by regulations under the Mason County Interim Resource Ordinance (77-93)*. This checklist is an important opportunity for identifying earlyin the permit process whether there will be any environmental regulations affecting the proposed development. _ I Owner &/;// s��/9ie�/� C�/f'IGtJ�/� Phone Vc&6 Site Address t!5� . -AlCity S* — Zip �— Owner Address O /IJ� City Stat "Zip S� Tax Parcel No. (Confirm with Assessors Office) —2 Zan qU -_�__ CJGn3 © Legal Description_ Lei L jaX 74 Lot Project Description Directions to site (Please attach map) ,o ,�c�� �� ;�L7 Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc. '0 r �•�/rrJ ,O E_gaa r✓ ,�� ��� Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas and resource lands are available for review at Mason County Department of Community Develdqme Us.ONY Department. A� g Do any of the following exist on this property or within 200 feet of this property? County Y No n .b . VL 1 1. Saltwater shoreline or a lake 20 acres or larger? r" �- to rn❑ 2. Rivers, streams, or creeks with year-round flow? < ❑ ❑ 3. Rivers, streams or creeks with intermittent flow but are within a clearly defin gchann {� ❑ 4. Lakes or ponds less than 20 acres in size? ❑ ff 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circums tances support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See County Maps for guidance.) ❑ ❑ ❑ 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for guidance.) ❑ 7. Floodplains? (See County Federal Emergency Management Maps Count y ty Seismic Hazard Map i for guidance.) ❑ 8. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any of the following programs: Co nt Yea No ❑ v 1. Agricultural Open Space Taxation Program, RCW 84.33 El ❑ ❑ 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. r t:: UUKGt L/aND6 & GKI I IGAL AREAS • SITE PLAN ?LEASE SNOW.THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE: + Location &dlmenslons of existing &proposed property boundaries. ► Approximate slope of land (grade &direction), topography. ► Identify legal access Including, width of all road right-of-ways &easements. P. Location of significant natural features(water bodies, rivers). ► Locate all existing & proposed structures,drainfields, wells &driveways. D. Project description Scale 1"_ / k�f�/�J' _ `�G✓C��5m9E North Arrow_ N l� T CS i, I state that I have answered the above truthfully to the best of my knowledge. Applicant/Owner �/�� l� Date FOR OFFICIAL USE ONLY Adjacent property. 5 Aeerr �r U Alf 41-7 Using County Resource Land Mobs, thisproperty is designated as: 1, Long-terra Commercial I orest _: �. Shoreline Master Program .....--2. Inholding Land .K.........5, Dees not apply. :....._. . 3. 'Mineral Resource Lard There is 540.00 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.