Loading...
HomeMy WebLinkAboutGRD2021-00002 - GRD Application - 3/8/2021 PSON c�a � MASON COUNTY PERMIT NO. y(Cl 262( -LbOC�2i W . 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 e>352` 615 W.Alder Street Shelton WA 98584 360 482-5269 Elma ext. �352 / zD LAND MODIFICATION PERMIT (Grading Permit) OWNER INFORMATION: CONTRACTOR INF0RMATI0NI;"1! q� er NAME: Beau Bakken NAME: Mark Kim SrOt' MAILING ADDRESS: 460 Old Belfair Hwy MAILING ADDRESS:PO Box 409 CITY: Belfair STATE: WA ZIP: 98528 CITY:Burlington STATE:WA ZIP: 98233 PHONE: (360)275-6711 CELL: PHONE: See cell CELL: (206) 650-1802 EMAIL:bbakken@northmasonrfa.com EMAIL : markkim@tricocompanies.com L&I REG# TRICOCL886Q8 EXP. 11/28/2022 PARCEL INFORMATION: � . PARCEL NUMBER(12 DIGIT NUMBER) 1232911�0030, 123291160060 FIRE DISTRIC LEGAL DESCRIPTION(ABBREVIATED): TR 3 of NE NE; LOT 2 of SP#928 of TR 6 of NE NE SITE ADDRESS 490 NE Old Belfair Highway CITY Belfair DIRECTIONS TO SITE ADDRESS Project is over two parcels,just north of existing fire station at 460 NE Old Belfair Hwy. Property is approximately 0.7 miles north of intersection of Highway 3 and NE Old Belfair Hwy on east side of road. IS PROPERTY WITHIN 200 FT: SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND ❑ SEASONAL RUNOFF❑ STREAM❑X DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES[] NO WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES ❑ NO ❑X TYPE OF JOB: EXCAVATION ® FILLING ❑ GRADING❑ CUTTING ❑ OTHER ❑ TOTAL SIZE OF PARCEL 3.4 ACRES/SQ FT SIZE OF AREA TO BE EFFECTED 2.0 ACRES/SQ FT ESTIMATED AMOUNTY OF CUBIC YARDS 2,500 CY DOES THE SITE HAVE SLOPES 14%OR GREATER YES❑ NON DESCRIBE SCOPE OF WORK Excavation and fill for 19,000 sf fire station replacement.Excavated soils will be repurposed onsite and structural fill imported.Closest designated wetland is over 500'away-stream drains to this wetland. WILL FILL BE BROUGHT ON SITE? IF YES,SITE ADDRESS: 490 NE Old Belfair Highway 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 © NO❑ WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES ❑ NO 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 ❑X NO❑ WILL THE LAND BE REPLANTED UPON COMPLETION? YES N NO❑ WELL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES ❑ NO N IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES ❑ NON 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, - -- -- -------` ----irties of interest regarding this project.The owner or authorized agent represents that the informa ,/ employees of Mason County access to the above described property and structure(s)for review )n becomes null&void if work or authorized construction is not commenced within 180 days of ��' 111�ww '1 r a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPE, IIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Date X OWNER/REPRESENTATIVE/CONTRACTOR (CIRCLE TO INDICATE) w , 1411112J